Hemodynamic effects of chest-knee position: comparison of perioperative propofol and sevoflurane anesthesia

There are limited data in the literature investigating the effects of anesthetic agents on cardiac output used in the chest-knee position. The aim of this study is to compare the effects of inhalation and total intravenous anesthesia on cardiac output in patients undergoing lumbar discectomy in the chest-knee position. Forty patients undergoing discectomy in the chest-knee position were allocated to 2 groups. The first group (GrS, n = 20) received sevoflurane after thiopental induction, while the second group (GrP, n = 20) received propofol induction and infusion. Heart rate (HR), mean arterial pressure (MAP), peripheral oxygen saturation, cardiac output (CO), and cardiac index (CI) were recorded. Groups were comparable in terms of HR and MAP. The differences related to anesthetic technique and position were statistically significant within each group. Cardiac output and CI were similar between the groups. Cardiac output and CI of GrP were found to be decreased in the chest-knee position and significantly elevated in the supine position after surgery (P < 0.05). There were significant decreases in the mean CO and CI values recorded after the chest-knee position in GrP. Sevoflurane is found to be superior when compared to propofol in patients undergoing surgery in the chest-knee position in terms of perioperative hemodynamic stability. Therefore, sevoflurane may be the anesthetic of choice, especially in patients operated on in the chest-knee position with suspected hemodynamic instability.