Effect of surgical position on total blood loss and hemodynamics in cervical unilateral open-door laminoplasty

English Keywords:Posterior cervical unilateral open door laminoplasty  Surgical position  Total bleeding  Systolic pressure  Heart rate

English Abstract:

  【Abstract】 Objectives: To discuss the effect of surgical position on total blood loss and hemodynamics in cervical unilateral open-door laminoplasty. Methods: A total of 49 patients undergoing cervical unilateral open-door laminoplasty under general anesthesia from January 2016 to December 2017 was selected, they were divided into two groups according to their different postures, 17 patients in prone position group(group A, 13 males/4 females) and 32 patients in sitting position group(group B, 28 males/4 females). To control the impact of gender disparity, 13 males randomly selected from group B and the 4 females in group B, formed group C. Systolic pressure and heart rate were measured and recorded in the morning of surgery date, 5 min after general anesthesia induction(supine position) and 5min after setting up position. The total amount of bleeding was operation bleeding plus postoperative drainage volume. Statistical methods were used to compare and analyze the data of these groups. Results: The difference of systolic blood pressure[d(BP)] in group A was -19±21mmHg, and the difference of heart rate [d(HR)] was -7±10/min. Systolic blood pressure and heart rate decreased with the change of position, and the difference was statistically significant(P<0.05). In group B, d(BP) was -12±23mmHg and d(HR) was -3±9/min, there was statistically significant difference in systolic blood pressure(P<0.05), but no significant difference in heart rate(P>0.05). The total blood loss, systolic blood pressure difference, heart rate difference were 272.94±105.82ml, -19±21mmHg, -7±10/min in group A, and 194.12±79.69ml, -3±21mmHg, -3±9/min in group C. The total blood loss in group A was more than that in group C(P<0.05). The decrease of systolic pressure in group A was significantly higher than that in group C(P<0.05). There was no significant difference in heart rate change between the two groups(P>0.05). Conclusions: Compared with prone position, sitting position in unilateral open-door operation could reduce the total blood loss. Although systolic blood pressure decreased in both postures and there was no significant difference in heart rate change between the two groups, sitting position could maintain a higher blood pressure value in a safe range.