Impact of Sitting or Semi-Setting Position of Patients During Breast Surgery on Hemodynamic Indexes

Background: Keeping the patient in a sitting or semi-sitting position for timeconsumingoncoplastic breast surgery is a major challenge for anesthesiologistsdue to several considerations. This cohort study was conducted on two groups ofpatients undergoing breast surgery.Methods: Study participants were categorized into two groups: one group wascomposed of normotensive women (group A) and the other group comprisedwomen with controlled hypertension (group B). After the induction of anesthesiain the supine position, the position was changed to sitting and the surgery wasdone in the sitting position. Hemodynamic monitoring included ECG, heart rate,non-invasive blood pressure (NIBP), invasive blood pressure (IBP), cardiacoutput (CO), arterial O2 saturation (SPO2), end-tidal CO2 (EtCO2), andbispectral index (BIS). The amount of administrated fluid and vasopressor wasrecorded for each patient.Any episode of hemodynamic instability was recorded,too.Results: Hemodynamic variation occurred in both groups, but the changeswere more significant in group B and the amount of fluid and vasopressoradministration was more prominent in group B. Changing the position caused nosignificant variation in BIS, SPO2, and EtCO2 in the two groups.Conclusions: The sitting position can be safe for time-consuming oncoplasticbreast surgery using adequate hemodynamic monitoring. Hemodynamic changesare more significant in patients with controlled hypertension, and more medicalinterference is needed for these patients.

Impact of Sitting or Semi-Setting Position of Patients During Breast Surgery on Hemodynamic Indexes Keywords:

Brest surgery , sitting position , hemodynamic changes