Trial reportBMC anesthesiology2015
Lithotomy versus jack-knife position on haemodynamic parameters assessed by impedance cardiography during anorectal surgery under low dose spinal anaesthesia: a randomized controlled trial.
Trial report in BMC anesthesiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02115178 (Haemodynamic Effects During Anorectal Surgery in Spinal Anaesthesia With Low Dose Hyperbaric Bupivacaine), which is not on this map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Haemodynamic Effects During Anorectal Surgery in Spinal Anaesthesia With Low Dose Hyperbaric Bupivacaine : a Comparison of the Jack -Knife and Lithotomy Position
Who cites it
6 citing papers in PubMed, 16 citations in OpenAlex.
- Hemodynamic effects of surgical positioning in patients undergoing percutaneous nephrolithotomy: a prospective study.BMC anesthesiology · 2025Observational
- Impact of surgical technique on hemodynamic instability in patients with pheochromocytoma: a single-centre retrospective cohort study.Surgical endoscopy · 2025Article
- General anesthesia with local infiltration reduces urine retention rate and prolongs analgesic effect than spinal anesthesia for hemorrhoidectomy.Frontiers in surgery · 2024Article
- Lithotomy versus prone position for perianal surgery: a randomized controlled trial.Annals of coloproctology · 2022Article
- Effect of Carbohydrate-Enriched Drink Compared to Fasting on Hemodynamics in Healthy Volunteers. A Randomized Trial.Journal of clinical medicine · 2022Article
- The effect of patient positions on perfusion index.BMC anesthesiology · 2018Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough the prone position providing better exposure for anorectal surgery is required it can cause a reduction of cardiac output and cardiac index. The goal was to compare haemodynamic changes assessed by impedance cardiography during anorectal surgery under low-dose spinal anaesthesia in lithotomy and jack-knife position.
methodsThe prospective randomized controlled study included 104, ASA I-II adult patients admitted for elective minor anorectal surgery, assigned to be performed in lithotomy (groupL, n = 52) or jack-knife position (groupJ, n = 52). After arrival to operating room the standard monitoring, impedance cardiography device was connected to the patient, and the following variables were recorded: cardiac output, cardiac index, systemic vascular resistance, stroke index at times of arrival to operating room, placement for, start and end of surgery and placement to bed. Spinal block was made in the sitting position with 4 mg of 0.5% hyperbaric bupivacaine and 10 μg of Fentanyl injected over 2 min. Comparison was based on haemodynamic changes between and inside groups over time. Student's t, chi square tests were used for statistical analysis with p < 0.05 regarded as statistically significant.
resultsThe reduction of cardiac output was statistically significant after placement of the patient into the prone position: from baseline 7.4+/-1.6 to 4.9+/-1.2 after placement for and 4.7+/-1.2 at the start and end of surgery (mean +/-SD l/min). The difference of cardiac output between groups was 2.0 l/min after positioning for and the start of surgery and 1.5 l/min at the end of surgery (p < 0.05). Mean cardiac index reduced from baseline 3.9+/-0.8 to 2.6+/-0.7 and 2.4+/-0.6 (mean+/-SD l/min/m(2)) in groupJ and between groups: by 1.0 l/min/m(2) after placement for, 1.1 at the start and 0.8 at the end of surgery (p < 0.05). Systemic vascular resistance increased from baseline 1080+/-338 to 1483+/-479 after placement for, 1523+/-481 at the start and 1525+/-545 at the end of surgery in groupJ (mean+/-SD dynes/sec/cm(-5), p < 0.05).
conclusionsAccording to impedance cardiography, jack-knife position after low-dose spinal anaesthesia produces transitory, but statistically significant reduction of cardiac output and cardiac index with increase of systemic vascular resistance, compared to insignificant changes in lithotomy position.
trial registrationClinical Trials NCT02115178.
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