Hemodynamic parameters during robotic radical prostatectomy in elderly patients with increased cardiac risk.
- Author:
Hee Jong LEE
1
;
Kyo Sang KIM
;
Jae Chul SHIM
;
Dong Guk CHA
;
Ji Seon JEONG
Author Information
1. Department of Anesthesiology and Pain Medicine, Hanyang University Hospital, Seoul, Korea. kimks@hanyang.ac.kr
- Publication Type:Original Article
- Keywords:
Cardiac diseases;
Elderly;
Hemodynamics;
Robot-assisted laparoscopic prostatectomy
- MeSH:
Aged;
Angina, Unstable;
Arterial Pressure;
Central Venous Pressure;
Head-Down Tilt;
Heart Diseases;
Heart Failure;
Heart Rate;
Hemodynamics;
Humans;
Insufflation;
Pneumoperitoneum;
Prostatectomy;
Supine Position;
Vascular Resistance
- From:Anesthesia and Pain Medicine
2012;7(3):249-255
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: We studied the hemodynamic changes associated with steep Trendelenburg position and prolonged pneumoperitoneum during robot-assisted laparoscopic prostatectomy in elderly patients with cardiac diseases. METHODS: Hemodynamic variables were measured at baseline supine position, at 30 min, 1, 2, 3 and 4 h during CO2 insufflation in post-Trendelenburg position, and after deflation in the supine position. RESULTS: In comparison with normal subjects, the cardiac index and systemic vascular resistance index of patients with cardiac diseases were significantly affected by the Trendelenburg position and pneumoperitoneum (P < 0.001). However, other variables of heart rate, mean arterial pressure and central venous pressure were not differed between the groups. CONCLUSIONS: We conclude that attention should be paid to maintain adequate hemodynamic status during prolonged pneumoperitoneum in the Trendelenburg position, and which is unfeasible in patients with severe heart failure and unstable angina.
