Hemodynamics and oxygen delivery in thyroid surgery patients under total intravenous anaesthesia

Abstract

AIM – to study the indicators of central hemodynamics and oxygen delivery in patients with thyrotoxicosis syndrome during the operation of thyroidectomy with the use of total intravenous anesthesia (TIVA). MATERIALS AND METHODS The study included 41 thyrotoxicosis syndrome patients (diffuse thyrotoxic goiter – 28 patients (68.3%), multinodular goiter – 12 (29.3%) and toxic adenoma – 1 patient (2.4%)) who underwent surgery under TIVA propofol with trachea intubation and mechanical lung ventilation. Doppler-echocardiography (Doppler-EchoCG) study was performed preoperatively, in the perioperative period systolic (SBP), diastolic (DBP) blood pressure, mean BP (MBP), pulse pressure (PP), heart rate (HR) were measured. Indices of central hemodynamics (cardiac output (CO), cardiac index (CI)) were studied using the esCCO™ method. Oxygen delivery (DO2) and peripheral vascular resistance (PVR) were calculated. The input data for calculating the indices of central hemodynamics, oxygen delivery were measured at the following stages: 1st stage – initial examination of the anesthesiologist; 2nd stage – patient's admission to the operating room; 3rd stage – after introductory anesthesia and intubation of the trachea; 4-th stage – the beginning of the operation; 5th stage – removal of thyroid gland; 6th stage – after suturing wounds (end of operation); 7th stage – 24 hours after the operation. RESULTS and DISCUSSIONAt the 1st stage the SBP, DBP, MBP, PP, HR were assessed as the same as the reference levels. At the 2nd stage, the amount of MBP increased by 8.21±0.02% compared to the first stage. At the third stage, the lowest indicators of MBP, PP, SBP, DBP were noted. At the third stage MBP was noted 68.17±1.12 mm Hg. The decrease was 34.61±0.88% (significant difference with the 2-nd stage, p