The effect on respiratory mechanics when using a Jackson surgical table in the prone position during spinal surgery

BACKGROUND: Respiratory dynamics may be monitored and evaluated indirectly by measuring the peak inspiratory pressure and plateau pressure. In this study, the respiratory dynamics of patients undergoing spinal surgery using a Jackson surgical table were observed with a device after converting their position from supine to prone. The effects of the dynamic compliance and airway resistance were observed from the changes in peak inspiratory pressure and plateau. METHODS: Twenty five patients were selected as subjects scheduled to undergo lumbar spine surgery. After intubation, the patients were ventilated mechanically with a tidal volume of 10 ml/kg and a respiration rate of 10/min. Anesthesia was maintained with sevoflurane 1.5%, nitrous oxide 2 L/min and oxygen 2 L/min. The peak inspiratory pressure, plateau pressure, resistance, compliance, arterial oxygen tension, carbon dioxide tension, heart rate and arterial blood pressure were measured at 10 minutes after the induction of anesthesia. These parameters were measured again 10 minutes after placing the patient in the prone position. RESULTS: The prone position did not significantly affect the arterial oxygen tension, carbon dioxide tension, blood pressure and heart rate, but significantly increased the peak inspiratory pressure and resistance and decreased the dynamic compliance. CONCLUSIONS: The peak inspiratory pressure was increased using a Jackson surgical table to minimize the abdominal pressure when converting from the supine to prone position. This might be due to a decrease in lung and chest compliance as well as an increase in airway resistance.