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The effect of airway obstruction on systolic arterial and central venous pressure during sedation in patients undergoing total knee replacement

Other Title
슬관절 전치환술을 받는 환자에서 진정 동안 발생한 기도 폐쇄가 수축기 혈압과 중심정맥압에 미치는 영향
Authors
박, 관식; 김, 대희; 문, 봉기; 박, 용덕; 채, 윤정
Citation
Korean journal of anesthesiology, 57(1):38-43, 2009
Journal Title
Korean journal of anesthesiology
ISSN
2005-64192005-7563
Abstract
Background: Severe respiratory variations of systolic arterial and central venous pressure (CVP) may increase the risk of embolic event in orthopedic patient. As airway obstruction during sedation can cause this respiratory variation, we evaluated the degree of variations of systolic blood (SBP) and CVP during airway obstruction period.



Methods: Fifteen females who had obstructed airway during total knee replacement (TKR) were included for the study. After regional anesthesia were established, SBP and CVP variations were analyzed according to the three periods; baseline, obstruction, and airway, respectively. Calculated CVP variables were similar to SBP variables as below: ?SBP = Expmax (maximal value at expiration) - Inspnadir (minimal value at inspiration), %?SBP = (?SBP/ Expmax) × 100. The frequencies of pulsus paradoxus (PP) and negative inspiratory CVP (NIC) were also measured.



Results: At obstruction period, ?SBP was 21.7 mmHg and 93.3% of patient had PP. Also, ?CVP was 19.3 mmHg and 100% of patient showed NIC. %?CVP (140%) was larger than %?SBP (16%). And ?CVP was inversely correlated with baseline and obstruction SBP and %?CVP was also inversely correlated with baseline CVP at obstruction period.



Conclusions: During airway obstruction in sedated TKR patients, variations of CVP are larger than those of SBP. So we have to monitor CVP continuously as well as SBP so as not to increase the possible risk of respiratory of variation.
Keywords
Airway obstructionRegional anesthesiaSedationTotal knee replacement
DOI
10.4097/kjae.2009.57.1.38
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Anesthesiology & Pain Medicine
AJOU Authors
박, 관식김, 대희문, 봉기채, 윤정
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