Considerações anestésicas para cistectomia robótica: estudo prospectivo

Oksar, Menekse; Akbulut, Ziya; Ocal, Hakan; Balbay, Mevlana Derya; Kanbak, Orhan

doi:10.1016/j.bjan.2013.09.007

Cited by 16 publications

(4 citation statements)

References 27 publications

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“…Recently, in two similar prospective studies, Oksar et al [ 10 , 11 ] monitored blood gas and end-tidal CO 2 values and hemodynamic parameters (heart rate, mean arterial, and central venous pressures) affected by CO 2 -pneumoperitoneum alone and in combination with Trendelenburg position and concluded that the main challenges associated with these conditions were the respiratory acidosis and “upper airway obstruction-like” clinical symptoms.…”

mentioning

confidence: 99%

Comment on “Evidence for Negative Effects of Elevated Intra-Abdominal Pressure on Pulmonary Mechanics and Oxidative Stress”

Ormantayev

Sepbayeva

Kosmas

et al. 2015

The Scientific World Journal

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confidence: 99%

Comment on “Evidence for Negative Effects of Elevated Intra-Abdominal Pressure on Pulmonary Mechanics and Oxidative Stress”

Ormantayev

Sepbayeva

Kosmas

et al. 2015

The Scientific World Journal

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“…The reduced HR is recovered to the baseline HR approximately 30 min after changing to the Trendelenburg position. 3,4 Moreover, in a steep Trendelenburg position, pulmonary compliance and functional residual capacity are decreased while peak inspiratory pressure is increased, making ventilation difficult and causing hypercapnia. 14 Further, CO 2 absorbed from the pneumoperitoneum may also cause hypercapnia, which in turn increases the risk for arrhythmia.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Bradycardia could also be induced by the Trendelenburg position during robotic surgery. 3,4 This current report describes a case of cardiac arrest following severe bradycardia caused by local intramyometrial injection of vasopressin in a patient with uterine leiomyoma undergoing robotic-assisted laparoscopic myomectomy and reviews the relevant literature.…”

Section: Introductionmentioning

confidence: 99%

Cardiac arrest caused by intramyometrial injection of vasopressin during a robotic-assisted laparoscopic myomectomy

et al. 2018

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Vasopressin is a locally-injected vasoconstrictor used to reduce bleeding during gynaecological surgery. However, even in these cases, vasopressin can induce adverse effects, including bradycardia, myocardial infarction and cardiac arrest. Elevated blood concentrations of vasopressin may induce the sympathoinhibitory reflex by increasing blood pressure and augment the sympathoinhibitory reflex by activating the area postrema. In addition, pneumoperitoneum formation needed for laparoscopy as well as physiological changes caused by steep Trendelenburg positions used during robotic surgeries may cause bradycardia. Shoulder braces used to prevent slipping from a steep Trendelenburg position may also be hazardous. This case report describes a 31-year-old female patient who underwent a scheduled robotic-assisted laparoscopic myomectomy in a steep Trendelenburg position. The patient experienced a cardiac arrest 2 min after the vasopressin injection and was treated accordingly. There were no abnormal findings on the postoperative laboratory studies, chest X-ray and electrocardiogram. The patient also had clear consciousness with no other notable symptoms. The patient was discharged on postoperative day 2. The report discusses the potential adverse effects of local vasopressin injection during robotic-assisted laparoscopic myomectomy.

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“…Due to the particular surgical conditions and because of its recent application, there still are many anesthetic implications that must be examined thoroughly—patients have to satisfy specific clinical requirements, identified through careful anesthesiologic assessments [3].…”

Section: Introductionmentioning

confidence: 99%

Recovery from Anesthesia after Robotic-Assisted Radical Cystectomy: Two Different Reversals of Neuromuscular Blockade

Claroni

Covotta

Torregiani

et al. 2019

JCM

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During robot-assisted radical cystectomy (RARC), specific surgical conditions (a steep Trendelenburg position, prolonged pneumoperitoneum, effective myoresolution until the final stages of surgery) can seriously impair the outcomes. The aim of the study was to evaluate the incidence of postoperative nausea and vomiting (PONV) and ileus and the quality of cognitive function at the awakening in two groups of patients undergoing different reversals. In this randomized trial, patients that were American Society of Anesthesiologists physical status (ASA) ≤III candidates for RARC for bladder cancer were randomized into two groups: In the sugammadex (S) group, patients received 2 mg/kg of sugammadex as reversal of neuromuscolar blockade; in the neostigmine (N) group, antagonization was obtained with neostigmine 0.04 mg/kg + atropine 0.02 mg/kg. PONV was evaluated at 30 min, 6 and 24 h after anesthesia. Postoperative cognitive functions and time to resumption of intestinal transit were also investigated. A total of 109 patients were analyzed (54 in the S group and 55 in the N group). The incidence of early PONV was lower in the S group but not statistically significant (S group 25.9% vs. N group 29%; p = 0.711). The Mini-Mental State test mean value was higher in the S group vs. the N group (1 h after surgery: 29.3 (29; 30) vs. 27.6 (27; 30), p = 0.007; 4 h after surgery: 29.5 (30; 30) vs. 28.4 (28; 30), p = 0.05). We did not observe a significant decrease of the PONV after sugammadex administration versus neostigmine use. The Mini-Mental State test mean value was greater in the S group.

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Considerações anestésicas para cistectomia robótica: estudo prospectivo

Abstract: Although the majority of patients generally tolerate robotic cystectomy well and appreciate the benefits, anesthesiologists must consider the changes in the cardiopulmonary system that occur when patients are placed in Trendelenburg position, and when pneumoperitoneum is created.

Cited by 16 publications

References 27 publications

Comment on “Evidence for Negative Effects of Elevated Intra-Abdominal Pressure on Pulmonary Mechanics and Oxidative Stress”

Comment on “Evidence for Negative Effects of Elevated Intra-Abdominal Pressure on Pulmonary Mechanics and Oxidative Stress”

Cardiac arrest caused by intramyometrial injection of vasopressin during a robotic-assisted laparoscopic myomectomy

Recovery from Anesthesia after Robotic-Assisted Radical Cystectomy: Two Different Reversals of Neuromuscular Blockade

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