The Comparison of Intraoperative Pressure Control and Volume Control Ventilation in Supine and Prone Positions: The Endless Debate

Objective: Position (supine and prone) changes have their essential effects on respiratory mechanics and pulmonary perfusion in patients under general anesthesia.These effects on respiratory mechanics, arterial blood gas, and hemodynamic parameters in patients who underwent percutaneous nephrolithotomy operation were compared in pressure and volume control ventilation (VCV) modes.Methods: This study prospectively evaluated 50 patients who underwent percutaneous nephrolithotomy.Patients were divided into groups of VCV and pressure control ventilation (PCV).Each group was divided further into two subgroups with supine and prone positions.General anesthesia was applied to all patients.Respiratory mechanics were recorded every 5 min.Arterial blood gas samples were repeated at each position change.Hemodynamic and respiratory parameters were simultaneously recorded.Results: Peak inspiratory pressure (Ppeak), plateau pressure (Pplato), and driving pressure (DP) of the VCV group were higher in the prone position than in the supine position.Ppeak, Pplato, and DP in the prone position were higher in the VCV group than the PCV group, and Horowitz ratio and compliance were lower.The Horowitz ratio of both groups was significantly higher in the prone than in the supine position.Conclusion: Despite the advantages, the superiority of PCV to VCV cannot be mentioned at the present.