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Positioning a patient in prone position under anaesthesia significantly alters cardiovascular physiology. Cervical myelopathy patients are known to have autonomic dysfunction. Such patients when positioned in prone position under anaesthesia carry a higher risk of developing hemodynamic changes and this can compromise spinal cord perfusion.
This prospective observational study was conducted on 30 patients with cervical myelopathy who underwent surgery in prone position at NIMHANS, Bangalore hospital. The non invasive cardiac output monitor (NICOM, Cheetah Medicals) was used to record various hemodynamic parameters. The hemodynamic parameters were recorded at baseline, post induction, post intubation, prior to prone position, post prone position, and every five minutes thereafter upto 20mins.
The hemodynamic parameters that were recorded using the NICOM monitor:
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Prone Positioning | Procedure | Noninvasive cardiac output monitoring parameters were recorded before and after prone positioning. |
| Measure | Description | Time Frame |
|---|---|---|
| Mean arterial pressure | Analysis of change in mean arterial pressure at following time points - before induction of anaesthesia, 2 minutes after anaesthetic induction, 2 minutes after intubation, before turning prone, immediately after turning prone and every 5 minutes thereafter till 20 minutes after positioning. | Before induction of anaesthesia to 20 minutes after prone positioning (end of study) |
| Measure | Description | Time Frame |
|---|---|---|
| Heart rate | Analysis of change in heart rate at following time points - before induction of anaesthesia, 2 minutes after anaesthetic induction, 2 minutes after intubation, before turning prone, immediately after turning prone and every 5 minutes thereafter till 20 minutes after positioning. | Before induction of anaesthesia to 20 minutes after prone positioning (end of study) |
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Inclusion Criteria:
Cervical myelopathy patients undergoing surgery in prone position with:
Exclusion Criteria:
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Patients with Cervical Myelopathy undergoing elective cervical decompression in prone position.
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| Name | Affiliation | Role |
|---|---|---|
| Nitin Manohar, MD, DNB, DM | National Institute of Mental Health and Neuro Sciences, Bangalore | Principal Investigator |
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There is no plan to share IPD with other researchers. If required, the Sponsor-Investigator may be contacted via email shared on this portal.
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| ID | Term |
|---|---|
| D016684 | Prone Position |
| ID | Term |
|---|---|
| D011187 | Posture |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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| Cardiac output | Analysis of change in cardiac output at following time points - before induction of anaesthesia, 2 minutes after anaesthetic induction, 2 minutes after intubation, before turning prone, immediately after turning prone and every 5 minutes thereafter till 20 minutes after positioning. | Before induction of anaesthesia to 20 minutes after prone positioning (end of study) |
| Stroke volume | Analysis of change in stroke volume at following time points - before induction of anaesthesia, 2 minutes after anaesthetic induction, 2 minutes after intubation, before turning prone, immediately after turning prone and every 5 minutes thereafter till 20 minutes after positioning. | Before induction of anaesthesia to 20 minutes after prone positioning (end of study) |
| Stroke volume variation | Analysis of change in stroke volume variation at following time points - before induction of anaesthesia, 2 minutes after anaesthetic induction, 2 minutes after intubation, before turning prone, immediately after turning prone and every 5 minutes thereafter till 20 minutes after positioning. | Before induction of anaesthesia to 20 minutes after prone positioning (end of study) |
| Total peripheral resistance | Analysis of change in total peripheral resistance at following time points - before induction of anaesthesia, 2 minutes after anaesthetic induction, 2 minutes after intubation, before turning prone, immediately after turning prone and every 5 minutes thereafter till 20 minutes after positioning. | Before induction of anaesthesia to 20 minutes after prone positioning (end of study) |