| Cardiovascular and respiratory effects of the degree of head-down angle during robot-assisted laparoscopic radical prostatectomy. | |
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MedLine Citation:
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PMID: 23348954 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Robot-assisted laparoscopic radical prostatectomy (RALP) requires a steep Trendelenburg position and CO(2) pneumoperitoneum for several hours to secure the surgical visual field. The present study was performed to investigate the influence of each angle of Trendelenburg position during RALP on cardiovascular and respiratory homeostasis. METHODS: Forty-seven ASA physical status 1 and 2 patients underwent open retropubic radical prostatectomy (RRP) or RALP. Patients receiving RALP were randomized to undergo the operation in the 20°, 25° or 30° Trendelenburg position. Heart rate (HR), mean arterial pressure (MAP), respiratory rate (RR), end-tidal CO(2) pressure (PetCO(2) ), tidal volume (Vt), peak inspiratory pressure (PIP) and dynamic compliance (Cdyn) were recorded during the operation. RESULTS: Angle of head-down tilt was significantly correlated with MAP, PIP and Cdyn, but not with HR, RR or PetCO(2) . MAP decreased gradually over time in each group in the Trendelenburg position with pneumoperitoneum. As the angle of head-down tilt became stronger, MAP, RR, PetCO(2) and PIP tended to increase and Cdyn tended to decrease. CONCLUSIONS: This study demonstrated that the degree of the head-down angle at RALP affected the cardiovascular and respiratory parameters. Pneumoperitoneum with head-down position in RALP influenced the cardiovascular and respiratory system to a greater extent than RRP, and these effects were stronger with deeper head-down angle. Copyright © 2013 John Wiley & Sons, Ltd. |
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Authors:
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Yoshifumi Kadono; Hiroshi Yaegashi; Kazuaki Machioka; Satoru Ueno; Sotaro Miwa; Yuji Maeda; Tohru Miyagi; Atsushi Mizokami; Yuka Fujii; Tsunehisa Tsubokawa; Ken Yamamoto; Mikio Namiki |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-1-25 |
Journal Detail:
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Title: The international journal of medical robotics + computer assisted surgery : MRCAS Volume: - ISSN: 1478-596X ISO Abbreviation: Int J Med Robot Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-1-25 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101250764 Medline TA: Int J Med Robot Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2013 John Wiley & Sons, Ltd. |
Affiliation:
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Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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