Вплив положення тіла під час операції на верхніх кінцівках на показники гемодинаміки та біспектрального індексу

Surgical interventions routinely have a significant impact on haemodynamic parameters due to a combination of factors: stress, anaesthetics, specific surgical procedures and perioperative position. Monitoring the bispectral index (BIS) helps to adjust anaesthesia to maintain stable haemodynamic status, minimise consciousness and potentially reduce recovery time. Objective. To assess the effect of body position on haemodynamic parameters and bispectral index during upper limb surgery under general anaesthesia with propofol solution. Methods. A prospective randomised study involved 70 patients divided into two groups: I (n = 35) — operated on in a semi-sitting position (SSP); II (n = 35) — anaesthetised in a standard supine position. The average age of patients in group I was (43.06 ± 11.92), in group II — (40.25 ± 10.14) years.nbsp; General anaesthesia was maintained with a 1% propofol solution depending on BIS monitoring indicators. To control the depth of sedation and adjust the propofol infusion, BIS monitoring COVIDEN was used. Results. Patients were comparable in terms of age, duration of surgery, and blood loss. When comparing haemodynamic values, the following changes were observed: a statistical difference in SBP (p lt; 0.001), DBP (p lt; 0.001), SAT (p lt; 0.001), slight tachycardia was observed compared to group II, but within the reference values (79.22 ± 9.76) beats per minute and (71.34 ± 7.77) beats per minute, respectively (p lt; 0.001). Reliable statistical values were obtained when calculating the dosage of 1% propofol solution; in group I, the average value was (4.87 ± 0.24) mg/kg/hour, while in group II it was (6.16 ± 0.49) mg/kg/hour (p lt; 0.001). Episodes of nausea and vomiting were observed in 12 patients in group I and in 5 patients in group II. The average time to spontaneous breathing recovery was longer in group I (p lt; 0.001), but no significant difference was found in the average time to extubation (p = 0.55). Conclusions. Anaesthesia monitoring using BIS allows to reduce the recovery time after awakening by reducing the total doses of anaesthetics administered. The infusion of anaesthetics depends not only on haemodynamic parameters but also on the perioperative body position.