Document Detail

Effects of surgical position on patients' arterial blood gases during percutaneous nephrolithotomy.
MedLine Citation:
PMID:  22903476     Owner:  NLM     Status:  In-Data-Review    
PURPOSE: To compare arterial blood gas analysis of patients who underwent percutaneous nephrolithotomy (PCNL) in flank position under ultrasonography guidance with PCNL in prone and supine positions under fluoroscopic guidance.
MATERIALS AND METHODS: In a clinical trial, a total of 90 patients with no upper urinary tract abnormalities were candidate for the PCNL. They were assigned into three groups using pseudorandomization method (30 patients in each group). Patients in group 1 underwent ultrasonography-guided PCNL in flank position. Patients in groups 2 and 3 underwent fluoroscopic-guided PCNL in prone and supine positions, respectively. Arterial blood gas was taken just before and 20 minutes after repositioning.
RESULTS: The patients' mean age was 40.8 ± 6.9, 39.4 ± 10.6, and 37.2 ± 11.1 years in flank, prone, and supine positions, respectively (P = .69). The mean body mass index was 27.8 ± 3.4, 26.7 ± 4.7, and 28.1 ± 5.1 kg/m² in flank, prone, and supine positions, respectively (P = .21). Arterial oxygen pressure (PaO₂) increased significantly in flank (111.7 ± 43.8 to 132.8 ± 58.1 mmHg; P = .01) and prone (118.6 ± 50.2 to 134.6 ± 58.5 mmHg; P < .001) positions and decreased nonsignificantly in supine group (121.7 ± 64.5 to 119.7 ± 60.9 mmHg; P = .23). With surgical positioning, there were no significant changes demonstrated in PaCO₂ and serum concentration of HCO₃ in the flank, prone, and supine groups.
CONCLUSION: We could suggest that flank and prone positions could improve patients' oxygenation during PCNL procedure.
Hossein Karami; Ali Reza Rezaei; Mohammad Mohsen Mazloomfard; Babak Javanmard; Behzad Lotfi; Amir Haji-Mohammadmehdi-Arbab
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Urology journal     Volume:  9     ISSN:  1735-546X     ISO Abbreviation:  Urol J     Publication Date:  2012  
Date Detail:
Created Date:  2012-08-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101286676     Medline TA:  Urol J     Country:  Iran    
Other Details:
Languages:  eng     Pagination:  553-6     Citation Subset:  IM    
Urology and Nephrology Research Center, Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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