Document Detail

Perioperative lower limb venous haemodynamics in patients under general anaesthesia.
MedLine Citation:
PMID:  15591327     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: This study prospectively determined the haemodynamic changes in the lower limb venous circulation during and shortly after elective abdominal surgery, performed under general anaesthesia. METHODS: Ten females, aged 36-65 yr, ASA I or II, undergoing total abdominal hysterectomy had their peak, mean and minimum velocities, diameter, volume flow and venous pulsatility (peak-minimum/mean velocity) measured in the left popliteal vein on recumbency with duplex at: (i) baseline, (ii) 15 min after induction, (iii) during surgery, and (iv) in recovery 30 min after extubation. Anaesthesia was induced with fentanyl and propofol, paralysis with vecuronium, maintenance with isoflurane in nitrous oxide 66%, and analgesia with morphine. Results are presented as percentage difference from baseline mean value. The Friedman and Wilcoxon([corrected(*)]) tests were applied. RESULTS: Mean velocity decreased by 23.6% during surgery and by 34.6% in recovery (P<0.05(*)). Minimum velocity was decreased by 56% during surgery and by 78% in recovery (P<0.05). The volume flow decreased by 26% during surgery, and by 54.4% in recovery (P<0.001). Diameter and peak velocity changed little at surgery and recovery (P>0.2). In contrast, the pulsatility increased by 30% on induction, 83% on surgery and 109% in recovery (P<0.05). Compared with baseline, haemodynamic changes on induction were small (P>0.1(*)). CONCLUSIONS: A significant decrease in the volume flow, mean and minimum velocities was noted during and immediately after elective total abdominal hysterectomy under general anaesthesia in ASA I and II patients. Flow changes in early recovery mirrored or enhanced those noted intraoperatively. Despite venous flow attenuation, haemodynamic readjustments produced a significant and progressive enhancement of venous flow pulsatility during the course of the procedure.
A L Knaggs; K T Delis; P Mason; K Macleod
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Publication Detail:
Type:  Journal Article     Date:  2004-12-10
Journal Detail:
Title:  British journal of anaesthesia     Volume:  94     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-02-10     Completed Date:  2005-03-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  292-5     Citation Subset:  IM    
Department of Anaesthesia, St Mary's Hospital, London W2 1NY, UK.
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MeSH Terms
Anesthesia, General*
Anesthetics, General / pharmacology
Blood Flow Velocity / drug effects
Hemodynamics / drug effects
Intraoperative Period
Leg / blood supply*
Middle Aged
Popliteal Vein / physiopathology,  ultrasonography
Postoperative Period
Pulsatile Flow / drug effects
Ultrasonography, Doppler, Duplex / methods
Reg. No./Substance:
0/Anesthetics, General

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