Effect of the 20° trendelenburg position on hypotension during induction of general anesthesia of patients undergoing gastrectomy / 临床麻醉学杂志

ABSTRACT

Objective To explore the effect of 20°trendelenburg position on hemodynamics during induction of general anesthesia of patients under gastrectomy.Methods One hundred and eighteen patients (77 males and 41 females,aged 50-60 years,ASA physical status Ⅰ or Ⅱ),scheduled for elective radical gastrectomy,were randomly divided into group A (n=40),group B (n=38) and group C (n=40).In group A,patients were placed in the supine position during induction of anesthesia,and vasopressors was administered when hypotension occurred.In group B,patients were placed in the supine position during induction of anesthesia and was placed in the 20°trendelenburg position when hypotension occurred,and vasopressor would be administered if blood pressure was not restored.In group C,patients were placed in the 20°trendelenburg position during induction of anesthesia,and vasopressors was administered when hypotension occurred.In all groups Lactated Ringer′s was infused at 15 ml·kg-1·h-1in 30 min before induction.Anesthesia was induced with propofol 2 mg/kg,sufentanil 0.5 μg/kg,rocuronium 0.9 mg/kg.The occurrence of hypotension and the total amounts of drug administrations were doccumented.Results Nineteen patients (47.5%) in group A,fourteen patients (36.8%) in group B and six patients (15.0%) in group C developed hypotention.The incidence of hypotension in group A and B was significantly higher than that in group C (P<0.05).In all groups the total dosage of ephedrine was used.Phenylephine was only used in the group A at a dose of 26.5±0.14 μg.The amounts of drug administrations in group B and C were significantly lower than that in group A (P<0.05).Two patients in group A went into a refractory hypotensive state.However,no patients in all groups fell into a serious arrhythmia state,so atropine was not used.Conclusion The 20°trendelenburg position during induction of general anesthesia of patients during gastrectomy can prevent hypotension during induction.This position is effective in the management of hypotension after the induction of general anesthesia and can decrease the amounts of drug administrations during induction of general anesthesia.