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Objective To investigate the effect of different operation positions on cardiac index (CI) and stroke volume variation (SVV) in the patients monitored by FloTrac/Vigileo system to provide some references for the hemodynamic management and liquid treatment of the patients.Methods Sixty patients scheduled for elective TV auxiliary thoracoscope radical operation of esophageal cancer.The CI and SVV changes were observed by using the FloTrac/Vigileo system.CI,SVV and CVP were recorded at 5 min after anesthesia induction (T0),5 min after converting to the position of head low feet high (T1),5 min after converting to the position of head high feet low (T2).Results Compared with T0,CI at T1 and T2 was decreased(P＜0.05);compared with T0,SVV at T1 was decreased and CVP was increased;SVV at T2 was increased and CVP was decreased(P＜0.05).Conclusion The operation position change may have a significant impact on the patient's CI,SVV and CVP.Focusing on the corresponding change can provide some references for the intraoperative hemodynamic management and liquid treatment.
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Objective To explore the effects of modified herringbone-Trendelenburg position during gynecological laparoscopic operation of the elderly. Methods A total of 60 elderly patients undergoing gynecological laparoscopic operation under general anesthesia were recruited and assigned to the observation group (30 cases) and control group (30 cases) by random digits table method with 30 cases each according to admitting time;Patients in the control group were placed in conventional Trendelenburg position, while the patients in the observation group were positioned in modified herringbone-Trendelenburg position .Intraocular pressure (IOP) were measured in the patients at anesthesia induction (T1),5 minutes after general anesthesia in supine position (T2) , and 5 minutes after pneumoperitoneum while in the operation position (T3) , every 30 minutes (times 4 to 11), while supine at the end of pneumoperitoneum (time 12) and before awakening (time 13);Patients were followed up at 24 h and 48 h after surgery, researcher investigate and record the scores of the Operation Position Comfort Questionnaire, the situation of the pain in the shoulder and postoperative complications of the lower limbs. Results There was no statistically significant difference (t=-1.098,-0.772,-0.656, P>0.05) of the IOP at T1, T2, T13. The IOP in the observation group had statistically significant difference compared with the control group at T3 to T12 (t=6.523-19.866, P<0.01). The incidence rate of the postoperative complications of the lower limbs in the observation group was 6.7%(2/30) lower than 26.7%(8/30) of the control group (χ2=4.320, P<0.05) and the VAS scores of the patients in the two groups was statistically significant (t=2.471, P<0.05). The incidence rate of the postoperative shoulder pain in the observation group was 10.0%(3/30) lower than 43.3%(13/30) of the control group (χ2=8.523, P<0.01), and the Visual Analogue Scale scores of the patients in the two groups was statistically significant (t=3.575, P<0.05).The scores of the Operation Position Comfort Questionnaire in the observation group was higher than the control group (t=-2.319, P<0.05). Conclusions Modified herringbone- Trendelenburg position can reduce the elevation of intraocular pressure in elderly patients without affecting the operation ,and effectively improve the comfort of the operation position of the patients, reduce the incidence rate of the shoulder pain and postoperative complications of the lower limbs, is conducive to the operation safety of elderly patients.
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Objective:To evaluate the clinical effects of amended concave position in gynecological laparoscopy surgery.Methods: Eighty ASAⅠ~Ⅱ patients with gynecological laparoscopy surgery were randomly divided into two groups, the patients in group A were adopted Trendelenburg position; the patients in group B were adopted amended concave position. The Ppeak and PETCO2 in the two groups were recorded during surgery, the time of extubation and the adverse effects as nausea, vomiting, shivering was recorded after surgery.Results: The Ppeak and PETCO2 of group A were higher than that of group B(t=2.526,t=2.838, t=2.881;P<0.05). The time of extubation of group A were higher than that of group B after surgery(t=2.515,t=2.436;P<0.05).Conclusion: Adopting amended concave position can reduce Ppeak and PETCO2 in gynecological laparoscopic surgery, and it is helpful for postoperative recovery of the patients with gynecological laparoscopy surgery.