The Use of Systolic Pressure Variation in Hemodynamic Monitoring during Deliberate Hypotension in Spine Surgery Reuven Pizov, MD,* Eran Segal, MD,? Leonid Kaplan, MD,$ Yzar Floman, MD,$ Azriel Perel, MD(j Department of Anesthesiology and Orthopedic Surgery, Hadassah University Hospital, Jerusalem, and the Department of’ Anesthesiology, Sheba Medical Center, Tel Hashomer, Israel. T/w systolic pressure variation. (SPV), which is the d$f &ence between the muxi~mal and minivnal systolic blood pressure (SP) during one ventilatovy cycle, wa.s studied in ten patients durin~gposterior spine fusion. To vninimize the blood loss, deliberate hypotension to u vnean blood pressure of 50 mvnHg was introduced by a continuous inffusion of sodium nitroprusside. SPV wus further divided into two components, *Lecturer

in Anesthesiology

tksident

in Anesthesiology

fKesident

in Orthopedics

#Professor

of Orthopedic

l(Associate Professor

A’up and A down, wing Sl’ during u short apneu as n reference point. All hemodynamic parameters were measured at the bqginnivq of anesthesia, 15 minute.c after induction cf hypotension, brfore cessution of nitropruxside infusion, und I5 minutes ufter the end of the hvpotensive period. During the hypotensive pehod (166 creased significantly from 4.83

Surgery

of. Anesthesiology

I

-+ 53 minute.,), cardiur, output (CO) dt)-

I.136 Llmin to 3.86

-+ 1.07 Llvnin (p < 0.05).

Heart rate (HR),

central venous pressure (CVP),

and pulmonuvy capillq

pressure (PCWP)

did not change during this period and bore no correlation to the

wedge

changes in CO. The only variables that changed during the hypotensiue period, in addition to

Address reprint requests to Dr. Perel at the Department of Anesthesiology, Sheba Medical Center, Tel Hashomer, Israel 5262 1. Supported by the Basic Research Foundation, Israel Academy of Sciences and Humanities.

CO, were SPV (from 13.1

0 1990 Butterworth

96

Publishers

+ 5.1 mmHg, p < O.(2),

and

.se