The Effect of Patient Positioning on Intraabdominal Pressure and Blood Loss in Spinal Surgery

Park, Chang Kil

doi:10.1213/00000539-200009000-00009

Cited by 93 publications

(26 citation statements)

References 9 publications

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“…Posterior surgery requires a prone patient with a free abdomen to keep epidural venous pressure low (the patient supported on a Wilson frame, for example, or a raised mattress with a hole for the abdomen). 84 For disc surgery, patients are placed in the knee-chest position with a well padded, secure support behind the upper thigh to support the patient's weight. This gives a horizontal lumbar spine with vertical intervertebral discs.…”

Section: Positioningmentioning

confidence: 99%

“…Blood loss during single level procedures, especially for intervertebral disc-related disease, should not be excessive, but during more extensive spinal surgery, it can be considerable; typically losses are 10±30 ml kg ±1 , a result of loss from decorticated bone and disruption of rich vascular networks. 113 124 The degree of blood loss is associated with: the number of spinal levels fused; body weight; 124 surgery for tumours; 77 raised intra-abdominal pressure in the prone position; 84 and the presence of DMD. 76 Blood loss is associated with increased operative time, delayed wound healing, wound infections, 120 and increased requirement for blood transfusion.…”

Section: Blood Conservationmentioning

confidence: 99%

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Anaesthesia for spinal surgery in adults

Raw¹,

Beattie

Hunter³

2003

British Journal of Anaesthesia

167

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The spectrum of spinal surgery in adult life is considerable. Anaesthesia for major spinal surgery, such as spinal stabilization following trauma or neoplastic disease, or for correction of scoliosis, presents a number of challenges. The type of patients who would have been declined surgery 20 yr ago for medical reasons, are now being offered extensive procedures. They commonly have preoperative co-morbid conditions such as serious cardiovascular and respiratory impairment. Airway management may be difficult. Surgery imposes further stresses of significant blood loss, prolonged anaesthesia, and problematical postoperative pain management. The perioperative management of these patients is discussed. The advent of techniques to monitor spinal cord function has reduced postoperative neurological morbidity in these patients. The anaesthetist has an important role in facilitating these methods of monitoring.

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Section: Positioningmentioning

confidence: 99%

Section: Blood Conservationmentioning

confidence: 99%

Anaesthesia for spinal surgery in adults

Raw¹,

Beattie

Hunter³

2003

British Journal of Anaesthesia

167

View full text Add to dashboard Cite

show abstract

“…When planning a posterior approach, the surgeon must take care to maintain low epidural venous pressures, which will aid in controlling blood loss that can be excessive in complicated spinal surgeries 26–28 . The use of padded chest rolls can help to lower venous pressure in the prone patient by freeing the abdomen from pressure.…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Traumatic L₂‐L₃ Spondyloptosis

Martin¹,

Raup²,

Hunter³

et al. 2009

AORN Journal

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Subluxation of a vertebra secondary to an injury (ie, traumatic spondyloptosis) is most commonly seen in the lumbosacral joint. This extremely rare spinal destabilization is caused by congenital defects, degeneration, tumors, infection, or trauma and is accompanied by severe neurologic debilitation. The patient's neurological function can be preserved when surgical team members have knowledge of spinal injuries, surgical interventions, positioning and its implications, and an awareness of the risks to the patient. Appropriate interventions can decrease complications, operative revisions, length of stay, morbidity and mortality, and hospital costs.

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“…Проведение мониторинга по методу импедансной кардиографии с использованием системы «NICCOMO» [3,6,13,18,19,27,29]. Анализ полученной нами в процессе ИКГ и ИПГ мониторинга информации позволил установить, что основными факторами, определяющими изменения гемодинамического статуса больного, которые должны учитываться в вертеброхирургической практике, являются интраоперационное положение, специфические особенности этапа хирургической операции, связанные с торакотомией, проявления фармакологических эффектов используемых для анестезиологической защиты препаратов.…”

Section: рисunclassified