Skip Navigation



BJA Advance Access published online on December 10, 2004
British Journal of Anaesthesia, doi:10.1093/bja/aei049
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
94/3/292    most recent
aei049v1
Right arrow E-Letters: Submit a response to the article
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Knaggs, A. L.
Right arrow Articles by Macleod, K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Knaggs, A. L.
Right arrow Articles by Macleod, K.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Board of Management and Trustees of the British Journal of Anaesthesia 2004
Accepted November 11, 2004

Clinical Investigation

Perioperative lower limb venous haemodynamics in patients under general anaesthesia{dagger}

A. L. Knaggs 1*, K. T. Delis 2, P. Mason 3, and K. Macleod 1

1 Department of Anaesthesia, St Mary's Hospital, London, UK
2 Mayo Clinic, Rochester, Minnesota, USA; Faculty of Medicine, Imperial College, London, UK
3 Department of Gynaecology, St Mary's Hospital, London, UK

* To whom correspondence should be addressed.
A. L. Knaggs, E-mail: akotow{at}aol.com


  Abstract

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.

Keywords: anaesthesia, general; measurement techniques, duplex ultrasound; surgery, abdominal; veins, lower limb venous haemodynamics.
{dagger} This study was presented at the Anaesthetic Research Society, Middlesborough, July 2003.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 QJMHome page
P.C. Malone and P.S. Agutter
The aetiology of deep venous thrombosis
QJM, September 1, 2006; 99(9): 581 - 593.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.