Document Detail


Effects of prolonged pneumoperitoneum on hemodynamics and acid-base balance during totally endoscopic robot-assisted radical prostatectomies.
MedLine Citation:
PMID:  12297911     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Dirk Meininger; Christian Byhahn; Matthias Bueck; Jochen Binder; Wolfgang Kramer; Paul Kessler; Klaus Westphal
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2002-09-26
Journal Detail:
Title:  World journal of surgery     Volume:  26     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-12-06     Completed Date:  2003-03-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1423-7     Citation Subset:  IM    
Affiliation:
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
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MeSH Terms
Descriptor/Qualifier:
Acid-Base Equilibrium / 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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