Cardiac function during steep Trendelenburg position and CO2 pneumoperitoneum for robotic-assisted prostatectomy: a trans-oesophageal Doppler probe study
✍ Scribed by Andres Falabella; Earl Moore-Jeffries; Michael J. Sullivan; Rebecca Nelson; Michael Lew
- Book ID
- 104583181
- Publisher
- Wiley (Robotic Publications)
- Year
- 2007
- Tongue
- English
- Weight
- 82 KB
- Volume
- 3
- Category
- Article
- ISSN
- 1478-5951
- DOI
- 10.1002/rcs.165
No coin nor oath required. For personal study only.
✦ Synopsis
Abstract
Background
Haemodynamic changes associated with pneumoperitoneum and steep Trendelenburg position were investigated in non‐obese, ASA I–II males, using general anaesthesia (sevoflurane in air/O~2~, 40%) undergoing robotic‐assisted laparoscopic prostatectomy.
Methods
A trans‐oesophageal echo‐Doppler probe (Arrow International) measured cardiovascular changes in heart rate (HR), mean arterial pressure (MAP), cardiac output (CO), systemic vascular resistance (SVR), stroke volume (SV) and aortic diameter (AoD) in 35 of 37 males. Assessments were conducted after induction of general anaesthesia in: the supine position; at 45° Trendelenburg; Trendelenburg + pnuemoperitoneum (intra‐abdominal 15 mmHg); and at the end of surgery in the supine position.
Results
The Trendelenburg position increased stroke volume. Trendelenburg position + pneumoperitoneum increased MAP and SVR and decreased AoD.
Conclusions
Pneumoperitoneum and steep Trendelenburg position significantly increase MAP and SVR. Trendelenburg position increased stroke volume. Pneumoperitoneum decreases aortic diameter. No significant changes in cardiac output or stroke volume were noted. Copyright © 2008 John Wiley & Sons, Ltd.