Comparative Analysis of Effect of Pressure-Controlled and Volume-Controlled Ventilation on Respiratory Mechanics and Hemodynamics in Patients Undergoing Lumbar Spine Surgery in Prone Position

Keywords

anesthesia - PCV - VC

Introduction: General anesthesia in prone position is related with increased airway pressure, decreased pulmonary, and thoracic compliance.

Aim: To compare pressure-controlled (PCV) and volume-controlled (VC) ventilation in patients undergoing lumbar spine surgery in prone position.

Methodology/Description: After ethics committee approval and written informed consent, a comparative randomized interventional study was conducted from March to June 2017. Patients were randomized in two groups of 30 each using sealed envelope method with 80% power and 97.5% confidence interval of the study. Patients of either sex, ASA grade I and II, age 20 to 65 years were included, while those with severe pulmonary disease and BMI > 30 kg/m² were excluded. Mean and standard deviation were calculated for quantitative data while proportions for qualitative data. For significance of difference, chi-squared test was used for proportions and unpaired t-test for mean. A p-value of < 0.05 was considered to be significant. Peak airway pressure (P-peak), PaO₂ levels, PaCO₂ levels, mean airway pressure, dynamic compliance, heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure were measured.

Results: Demographic parameters and perioperative hemodynamic values were comparable with no significant statistical difference. The P-peak levels were significantly higher in Group VC as compared with Group PC (p < 0.05). Dynamic compliance levels during prone position were higher in Group PC when compared with Group VC. Postoperative PaO₂ level was significantly higher in Group PC compared with Group VC.

Conclusion: According to our study, PCV mode is associated with lower P-peak levels during prone position and better oxygenation postoperatively. We concluded that PCV mode might be more appropriate in prone position during anesthesia.

 

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• References

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