Anesthetic considerations for robotic cystectomy: a prospective study
Background and objectives: Robotic cystectomy is rapidly becoming a part of the standard surgical repertoire for the treatment of prostate cancer. Our aim was to describe respiratory and hemodynamic challenges and the complications observed in robotic cystectomy patients. Patients: Sixteen patients...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2014-03-01
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| Series: | Brazilian Journal of Anesthesiology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0104001413001954 |
| _version_ | 1797998201150636032 |
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| author | Menekse Oksar Ziya Akbulut Hakan Ocal Mevlana Derya Balbay Orhan Kanbak |
| author_facet | Menekse Oksar Ziya Akbulut Hakan Ocal Mevlana Derya Balbay Orhan Kanbak |
| author_sort | Menekse Oksar |
| collection | DOAJ |
| description | Background and objectives: Robotic cystectomy is rapidly becoming a part of the standard surgical repertoire for the treatment of prostate cancer. Our aim was to describe respiratory and hemodynamic challenges and the complications observed in robotic cystectomy patients. Patients: Sixteen patients who underwent robotic surgery between December 2009 and January 2011 were prospectively enrolled. Main outcome measures were non-invasive monitoring, invasive monitoring and blood gas analysis performed at supine (T0), Trendelenburg (T1), Trendelenburg + pneumoperitoneum (T2), Trendelenburg-before desufflation (T3), Trendelenburg (after desufflation) (T4), and supine (T5) positions. Results: There were significant differences between T0 − T1 and T0 − T2 with lower heart rates. The mean arterial pressure value at T1 was significantly lower than T0. The central venous pressure value was significantly higher at T1, T2, T3, and T4 than at T0. There was no significant difference in the PET-CO2 value at any time point compared with T0. There were no significant differences in respiratory rate at any time point compared with T0. The mean f values at T3, T4, and T5 were significantly higher than T0. The mean minute ventilation at T4 and T5 were significantly higher than at T0. The mean plateau pressures and peak pressures at T1, T2, T3, T4, and T5 were significantly higher than the mean value at T0. Conclusions: Although the majority of patients generally tolerate robotic cystectomy well and appreciate the benefits, anesthesiologists must consider the changes in the cardiopulmonary system that occur when patients are placed in Trendelenburg position, and when pneumoperitoneum is created. Keywords: Robotic cystectomy, Anesthesia, Anesthesiologist |
| first_indexed | 2024-04-11T10:43:44Z |
| format | Article |
| id | doaj.art-c355f01084a24531ae3a9058cb18e5ea |
| institution | Directory Open Access Journal |
| issn | 0104-0014 |
| language | English |
| last_indexed | 2024-04-11T10:43:44Z |
| publishDate | 2014-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Anesthesiology |
| spelling | doaj.art-c355f01084a24531ae3a9058cb18e5ea2022-12-22T04:29:06ZengElsevierBrazilian Journal of Anesthesiology0104-00142014-03-01642109115Anesthetic considerations for robotic cystectomy: a prospective studyMenekse Oksar0Ziya Akbulut1Hakan Ocal2Mevlana Derya Balbay3Orhan Kanbak4Department of Anesthesiology and Reanimation, Ankara Ataturk Training and Research Hospital, Ankara, Turkey; Corresponding author.Department of Urology, Ankara Ataturk Training and Research Hospital, Ankara, TurkeyDepartment of Anesthesiology and Reanimation, Ankara Ataturk Training and Research Hospital, Ankara, TurkeyDepartment of Urology, Ankara Ataturk Training and Research Hospital, Ankara, TurkeyDepartment of Anesthesiology and Reanimation, Ankara Ataturk Training and Research Hospital, Ankara, TurkeyBackground and objectives: Robotic cystectomy is rapidly becoming a part of the standard surgical repertoire for the treatment of prostate cancer. Our aim was to describe respiratory and hemodynamic challenges and the complications observed in robotic cystectomy patients. Patients: Sixteen patients who underwent robotic surgery between December 2009 and January 2011 were prospectively enrolled. Main outcome measures were non-invasive monitoring, invasive monitoring and blood gas analysis performed at supine (T0), Trendelenburg (T1), Trendelenburg + pneumoperitoneum (T2), Trendelenburg-before desufflation (T3), Trendelenburg (after desufflation) (T4), and supine (T5) positions. Results: There were significant differences between T0 − T1 and T0 − T2 with lower heart rates. The mean arterial pressure value at T1 was significantly lower than T0. The central venous pressure value was significantly higher at T1, T2, T3, and T4 than at T0. There was no significant difference in the PET-CO2 value at any time point compared with T0. There were no significant differences in respiratory rate at any time point compared with T0. The mean f values at T3, T4, and T5 were significantly higher than T0. The mean minute ventilation at T4 and T5 were significantly higher than at T0. The mean plateau pressures and peak pressures at T1, T2, T3, T4, and T5 were significantly higher than the mean value at T0. Conclusions: Although the majority of patients generally tolerate robotic cystectomy well and appreciate the benefits, anesthesiologists must consider the changes in the cardiopulmonary system that occur when patients are placed in Trendelenburg position, and when pneumoperitoneum is created. Keywords: Robotic cystectomy, Anesthesia, Anesthesiologisthttp://www.sciencedirect.com/science/article/pii/S0104001413001954 |
| spellingShingle | Menekse Oksar Ziya Akbulut Hakan Ocal Mevlana Derya Balbay Orhan Kanbak Anesthetic considerations for robotic cystectomy: a prospective study Brazilian Journal of Anesthesiology |
| title | Anesthetic considerations for robotic cystectomy: a prospective study |
| title_full | Anesthetic considerations for robotic cystectomy: a prospective study |
| title_fullStr | Anesthetic considerations for robotic cystectomy: a prospective study |
| title_full_unstemmed | Anesthetic considerations for robotic cystectomy: a prospective study |
| title_short | Anesthetic considerations for robotic cystectomy: a prospective study |
| title_sort | anesthetic considerations for robotic cystectomy a prospective study |
| url | http://www.sciencedirect.com/science/article/pii/S0104001413001954 |
| work_keys_str_mv | AT menekseoksar anestheticconsiderationsforroboticcystectomyaprospectivestudy AT ziyaakbulut anestheticconsiderationsforroboticcystectomyaprospectivestudy AT hakanocal anestheticconsiderationsforroboticcystectomyaprospectivestudy AT mevlanaderyabalbay anestheticconsiderationsforroboticcystectomyaprospectivestudy AT orhankanbak anestheticconsiderationsforroboticcystectomyaprospectivestudy |