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Observational Study
. 2023 Jul:113:93-98.
doi: 10.1016/j.jocn.2023.05.007. Epub 2023 May 23.

The spine intra-abdominal pressure (SIAP) trial. A prospective, observational, single arm, monocenter study looking at the evolutions of the IAP prior, during and after spine surgery

Pram Depauw  1 , F van Eijs  2 , C Wensing  3 , R Geuze  4 , H van Santbrink  5 , M Malbrain  6 , J J De Waele  7
Affiliations
Observational Study

The spine intra-abdominal pressure (SIAP) trial. A prospective, observational, single arm, monocenter study looking at the evolutions of the IAP prior, during and after spine surgery

Pram Depauw et al. J Clin Neurosci. 2023 Jul.

Abstract

Background and aims: Both anaesthesiologists and spine surgeons consider the intra-abdominal pressure (IAP) as an important peri-operative factor affected by patient positioning. We assessed the change in IAP caused by using a thoraco pelvic support (inflatable prone support, IPS) with the subject under general anesthesia. The IAP was measured before, during and immediately after surgery.

Methods: The Spine Intra-Abdominal Pressure study (SIAP trial) is a prospective, single-arm, monocenter, observational study looking at changes in IAP prior, during and after spine surgery. The objective is to assess the change in IAP, measured via an indwelling urinary catheter, using the inflatable prone support (IPS) device during prone positioning of patients in spinal surgery.

Results: Forty (40) subjects requiring elective lumbar spine surgery in prone position were enrolled after providing informed consent. The inflation of the IPS results in a significant decrease of IAP (from a median of 9.2 mmHg to 6.46 mmHg (p < 0.001)) in patients undergoing spine surgery in prone position. This decrease in IAP was maintained throughout the procedure despite the discontinuation of muscle relaxants. No serious adverse events or unexpected adverse events occurred.

Conclusion: The use of the thoraco-pelvic support IPS device was able to significantly lower the IAP during spine surgery.

Keywords: IAP; IPS; Inflatable Prone Support; Intra-abdominal pressure; Prone position; Prone ventilation; Spine surgery; Vertebral venous plexus.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Disclosures The corresponding author, Dr Paul Depauw, is involved as an ad hoc consultant for Ergotrics. Dr Paul Depauw founded Ergotrics in 2014 and still holds stocks in the company. His scientific interest is in Intra-Abdominal Pressure (IAP) in neurosurgery and spine surgery. The Principal Investigalor, Dr Frank van Eys, anesthesiologist, has no involvements that might raise the question of bias in the work reported or in the conclusions, implications, or opinions stated. The other authors also have no involvements that might raise the question of bias in the work reported or in the conclusions, implications, or opinions stated.

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