Pressure Controlled Ventilation versus Volume-Controlled Ventilation Regarding Hemodynamics and Stress Response for Posterior Lumbar Spine Surgeries in The Prone Position

Abstract

Background: Prone positioning may induce alterations of airway pressures and hemodynamic that may affect intraoperative blood loss. Ventilation mode may modify these alterations. Objective: Our study aimed to differences between pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV) in their effects on hemodynamic changes during posterior lumbar surgeries performed in the prone position. Patients and Methods: This is a prospective randomized controlled study, which was performed in the Department of Anaesthesiology and Surgical ICU, Aswan university, Egypt at the duration from 1-6-2017 to 13-12-2018 for 60 patients who had posterior lumbar spine surgery in prone position who were eligible to inclusion/exclusion criteria divided into two groups; Group (I) were received VCV mode (n = 30) and Group (II) were received PCV mode (n = 30) then study parameters were recorded intraoperatively and postoperatively in the two groups of ventilation modes. Results: As regarding heart rate, mean arterial blood pressure, serum glucose level, and serum cortisol level, they were statistically significantly lower in PCV group than VCV group both intraoperative and postoperative which reflects that stress response is lower with PCV more than VCV and that may have also a rule in decreasing intraoperative blood loss and improving the surgical field in these surgeries. Conclusions: for lumbar spine surgeries in the prone position, PCV was associated with decreased HR, blood pressure, cortisol, glucose levels compared with VCV. The stress response is lesser with PCV which is better for this type of patients.