Page 90 - TheTalents 2018 Debate2

Patient Safety:
Anesthetic Consideration Improved in Supine PCNL
NO REPORTED CASES in the literature for • Improved parameters for high risk patients:
Intraocular pressure/ Post
PCNL
*Use a prone helmet and neutral head
• Reduced intraocular pressure
Anesthetic Blindness:
• Increase HR, decrease BP, dec cardiac index, decrease venous return due to positioning, rather than lateral neck
thoracic pressure, increase peak pressures rotation
• Patients with a severely impaired FEV1 have a 5x increased risk of
Severely compromised FEV1 have a 5x
• “...patients with marginal heart and lung function do not tolerate the prone position well.”
cardiovascular death at baseline. Therefore this population would be high
risk for any surgery/complication.
higher risk of CV death then the general population.
-Pressure controlled ventilation > Volume controlled ventilation improves pressures, O2,reduces stress response
Worsened Respiratory function and, Compression of IVC
Decreases the number of times re- positioned after anesthetized
Split leg position allows retrograde contrast, or ECIRS