The effect of prone position on the integrated pulmonary index (IPI) score in lumbar disc surgeries performed with spinal anesthesia

Abstract

Aim: It is a known fact that the prone position has curative effects on respiratory parameters. To evaluate the effect of prone position on respiratory status in lumbar discectomy operations with spinal anesthesia using integrated pulmonary index (IPI), which is a novel tool that incorporates different respiratory parameters.

Methods: A total of 40 patients were enrolled in this prospective, observational study between December 2020 and February 2021. The IPI parameters included end-tidal carbon dioxide, respiratory rate, pulse rate and oxygen saturation recorded at the time of admission to the operating room, at ten minutes after spinal anesthesia administration, at ten minutes following prone positioning and ten minutes after the end of the operation.

Results: The mean end-tidal carbon dioxide value significantly increased after prone positioning and at the end of the operation. The mean oxygen saturation similarly increased at the end of the operation. There was a moderately significant correlation between the mean IPI scores after prone positioning and ten minutes after the administration of spinal anesthesia.

Conclusion: Prone position did not show any negative effect on respiratory mechanics as obtained from IPI, while it increased oxygenation. IPI may be a valuable tool in clinical practice to monitor respiratory mechanics in the prone position in patients undergoing lumbar disc surgeries.