| Effects of prolonged pneumoperitoneum on hemodynamics and acid-base balance during totally endoscopic robot-assisted radical prostatectomies. | |
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MedLine Citation:
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PMID: 12297911 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Laparoscopic techniques have become a standard approach for diagnostic and therapeutic procedures in many surgical disciplines. Recent progress in endoscopic surgery is based on the integration of computer-enhanced telemanipulation systems. Because robot-assisted radical prostatectomies take up to 10 hours, the present study was performed to evaluate the effects of prolonged intraperitoneal CO2 insufflation on hemodynamics and gas exchange in 15 patients with prostate cancer. When CO2 insufflation was initiated, peak inspiratory pressure increased and reached significant values after a 1.5-hour period of intraperitoneal CO2 insufflation. With the release of CO2, peak inspiratory pressure decreased close to baseline values. A significant increase in heart rate was observed after a 4-hour period of increased intraabdominal pressure. Mean arterial blood pressure and central venous pressure remained stable during CO2 insufflation. Minute ventilation was adjusted according to repeated blood gas analyses to maintain pH, base excess (BE), bicarbonate (HCO3?), and PaCO2 within physiologic ranges. The present data show, that prolonged CO2 insufflation during totally endoscopic robot-assisted radical prostatectomy results in only minor changes in hemodynamics and acid-base status. Because of the limited experience with long-term pneumoperitoneum, we consider invasive haemodynamic monitoring and repeat blood gas analysis essential for such operations. |
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Authors:
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Dirk Meininger; Christian Byhahn; Matthias Bueck; Jochen Binder; Wolfgang Kramer; Paul Kessler; Klaus Westphal |
Publication Detail:
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Type: Comparative Study; Journal Article Date: 2002-09-26 |
Journal Detail:
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Title: World journal of surgery Volume: 26 ISSN: 0364-2313 ISO Abbreviation: World J Surg Publication Date: 2002 Dec |
Date Detail:
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Created Date: 2002-12-06 Completed Date: 2003-03-24 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7704052 Medline TA: World J Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1423-7 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, Intensive Care Medicine, and Pain Control, JW Goethe-University Hospital Center, Theodor-Stern-Kai 7, D-60590, Frankfurt, Germany. dirk_meininger@gmx.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acid-Base Equilibrium
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physiology* Blood Gas Analysis Central Venous Pressure Cohort Studies Follow-Up Studies Hemodynamics / physiology* Humans Laparoscopy / adverse effects, methods* Male Middle Aged Pneumoperitoneum, Artificial / adverse effects*, methods Probability Prospective Studies Prostatectomy / instrumentation, methods* Prostatic Neoplasms / diagnosis, surgery* Risk Assessment Robotics / methods* Statistics, Nonparametric Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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