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Korean Journal of Anesthesiology 2006;51(6):675-679.
DOI: https://doi.org/10.4097/kjae.2006.51.6.675   
Effects of Patients' Position on Blood Pressure and Heart Rate during Spinal Anesthesia for Axillo-femoral Bypass Surgery.
Soo Kyoung Park, Young Kug Kim, Sung Lyang Chung, Ji Hyun Chin, Chung Lee, Yu Mi Lee
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ylee@amc.seoul.kr
Hypotension is one of the most common complications from the spinal anesthesia frequently used for surgery on the lower abdomen or extremities. It might be important in prognostic improvements to maintain cardiovascular homeostasis in elderly or patients with cardiovascular diseases. This study evaluated the effect of the patients' position on the preservation of cardiovascular stability when elderly patients suffering from hypertension undergo surgery for an axillo-femoral arterial bypass.
24 patients with hypertension undergoing an elective axillo-femoral bypass surgery were examined. The patients were randomly allocated into two groups (Lateral 20 min group: patients with lateral position for 20 min after spinal anesthesia; Supine group: patients with the supine position immediately after spinal anesthesia). The observers recorded the hemodynamic variables, as well as the loss of sensation on both sides.
Considering the changes in the arterial blood pressure and heart rate from the baseline values, patients in the supine group showed a greater decrease in arterial blood pressure and heart rate (P < 0.05). In the lateral 20 min group, there was a lower block level of cold sensation that reflected the sympathetic blockade at the non-operated site (P < 0.05).
The lateral decubitus position for 20 min after spinal anesthesia can contribute to the maintenance of cardiovascular stability during unilateral axillo-femoral bypass surgery in elderly patients with hypertension.
Key Words: axillo-femoral bypass surgery; hypotension; spinal anesthesia


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