Effect of spine frame on the changes in respiratory dynamics in prone patients under general anaesthesia- a prospective, observational study

Abstract

Background and Aims: The prone position is one of the common surgical positions used in clinical practice. Manoeuvring patients from supine to a prone position can impact respiratory dynamics and result in haemodynamic variations. Methods: This study included 64 patients and was conducted after obtaining approval from the ethics committee and registration of the trial. The primary objective was to evaluate the changes in peak inspiratory pressure (PIP), plateau pressure (Pplat) and mean airway pressure (MAP) in patients undergoing surgery under general anaesthesia in the prone position with (Group S) and without (Group P) spine frame. The secondary objective was to evaluate and compare the variations in heart rate and blood pressure. Results: On turning the patient prone, there was statistically significant increase in median PIP (Group S 4 cmH2O vs. Group P 0.5 cmH2O, P < 0.001), Pplat (Group S 3.5 cmH2O vs. Group P 1 cmH2O, P = 0.004) and dynamic compliance (Group S −5.513 vs. Group P −2.78, P < 0.004). Conclusions: Our study found that prone positioning with a spine frame led to a significantly greater increase in airway pressures and a decrease in dynamic compliance when compared to patients positioned prone without the spine frame.