Tidal Volume as a Predictive Factor for Hypotension Associated with Prone Positioning in Patients Undergoing Spine Surgery
DOI:
https://doi.org/10.51273/esc25.251321118Keywords:
Spine surgery, , intraoperative hypotension, prone positioning, tidal volume, factor.Abstract
Abstract
Objective: To investigate whether tidal volume serves as a predictive factor for intraoperative hypotension
associated with prone positioning in patients undergoing spine surgery.
Material and Methods: This cross-sectional study conducted at Hameed Latif Hospital in Lahore examined
the risk factors associated with intraoperative hypotension in 171 patients. Data were analyzed utilizing
SPSS version 26, employing statistical comparisons through the Student t-test, Mann-Whitney test, χ2 test, or
Fisher's exact test. Univariate logistic regression indicated predictors of hypotension during positional shifts,
whereas multivariate regression incorporated one variable for every five events. The variables examined
encompassed demographics, comorbidities, pharmacological treatments, and anesthetic factors.
Results: The study analyzed many characteristics in patients with and without hypotension during surgery.
Patients with hypotension were predominantly male (70.6% vs. 51.5%, p = 0.031) and exhibited specific
comorbidities, including neurologic disease (23.5% vs. 11.1%, p = 0.046), renal disease (11.8% vs. 3.5%, p =
0.042), and cardiac disease (17.6% vs. 5.3%, p = 0.027). Furthermore, they exhibited a greater BMI (26.5
kg/m² compared to 25.1 kg/m², p = 0.049) and a higher likelihood of being prescribed ARB/ACEi medicines
(35.3% versus 22.8%, p = 0.042). The administration of beta-blockers (odds ratio = 3.82, 95% CI = 1.12
13.03, p = 0.032) and mean arterial pressure (MAP) in the supine position (odds ratio = 1.09, 95% CI = 1.01
1.18, p = 0.017) correlated with elevated odds of hypotension. Furthermore, age (odds ratio = 1.04, 95% CI =
1.01-1.07, p = 0.018) and BMI (odds ratio = 0.92, 95% CI = 0.85-0.99, p = 0.029) were recognized as
potential factors contributing to hypotension. Tidal volumes exceeding 10 ml/kg exhibited the greatest
occurrence of hypotension, resulting in an average decline in mean arterial pressure of 25 mmHg.
Conclusion: In summary, higher tidal volumes were factor of an increased risk of hypotension during prone
positioning. Intraoperative hypotension is associated with male gender, certain comorbidities, and higher
BMI.
Keywords: Spine surgery, intraoperative hypotension, prone positioning, tidal volume, factor.
How to cite: Tariq SMA, Khan SA, Tayyeb M, Khan S, Salman A, Butt MUI. Tidal Volume as A Predictive Factor for
Hypotension Associated with Prone Positioning in Patients Undergoing Spine Surgery. Esculapio - JSIMS
2025;21(01): 97-104
DOI: https://doi.org/10.51273/esc25.251321118
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