Effects of Patient Positioning on Hemodynamic Parameters During Laparoscopic Surgery: A Comparative Study Between Hypertensive and Normotensive Patients

Abstract

Objective: This prospective observational study aimed to assess the effects of different surgical positions on hemodynamic parameters in hypertensive and normotensive patients during laparoscopic procedures. Methods: Seventy patients were enrolled and divided into hypertensive and normotensive groups. Patients underwent laparoscopic surgeries in Trendelenburg, reverse Trendelenburg, and supine positions. Hemodynamic parameters were monitored using a non-invasive cardiac output monitoring system at multiple time points during the procedure. Results: Significant hemodynamic variations were observed across different positions. Hypertensive patients demonstrated more pronounced changes compared to normotensive patients. Cardiac output decreased by 34% in reverse Trendelenburg position for hypertensive patients, while mean arterial pressure increased by 35% in the supine position. Total peripheral resistance showed an 81% increase in the supine position for hypertensive patients. Conclusion: Surgical positioning significantly impacts hemodynamic parameters, with hypertensive patients exhibiting more substantial cardiovascular responses. The study emphasizes the importance of individualized anesthetic management and careful monitoring during laparoscopic procedures.