Hemodynamic, renal and hormonal effects of lung protective ventilation during robot-assisted radical prostatectomy, analysis of secondary outcomes from a randomized controlled trial

Høyer, Sidse; Mose, Frank Holden; Ekeløf, Peter; Jensen, Jørgen Bjerggaard; Bech, Jesper Nørgaard

doi:10.1186/s12871-021-01401-x

Cited by 2 publications

(2 citation statements)

References 30 publications

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“…Существует несколько теорий механизма увеличения ОПСС. Во-первых, это явление может возникать в ответ на механическую компрессию артерий в брюшной полости или на стимуляцию ренин-ангиотензиновой системы в результате резкого уменьшения кровообращения в почках [32]. В других случаях ОПСС увеличивается рефлекторно на фоне сниженного венозного возврата и сердечного выброса.…”

Section: изменение центральной гемодинамики и органного кровотока при...unclassified

Anesthetic aspects of robot-assisted surgery (a review)

Богданов

Khusaenova

Husaenova

et al. 2023

Tihookeanskij medicinskij žurnal

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The introduction of modern robot-assisted and laparoscopic methods of surgical interventions have extended the range of surgical indications, at the same time as raising a number of specific problems related to the technical features of minimally invasive treatment. This fact makes us consider the effect of surgical aggression on the patient from a new perspective. In particular, the influence of pneumoperitoneum and the patient’s position on venous return, regional blood flow changes, and concomitant shifts of some homeokinetic systems require elucidation. This article reviews the available literature to describe the main features of anesthesia during robot-assisted surgical interventions. Recommendations from systematic reviews and meta-analyses were used. The search depth comprised the period of 12 years (2011–2022). Such factors as antiphysiological position on the operating table, tense carboxyperitoneum, and carboxythorax affect almost all organs and many regulatory mechanisms, thus having a pathological effect on the cardiovascular and respiratory systems, kidney, liver, intestines, blood coagulation system, immune system, and thermoregulation mechanisms. These effects are particularly pronounced in patients with concomitant diseases. In addition to knowledge in the field of pathophysiology, surgeons should be capable of predicting the course of events to take actions aimed at preventing the development of complications. Robot-assisted surgical interventions, although being less traumatic, are characterized by specific features that should be taken into account when preparing a patient to undergo surgery, selecting an optimal method of surgical intervention, and managing the patient in the intra- and postoperative period with rehabilitation.

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Section: изменение центральной гемодинамики и органного кровотока при...unclassified

Anesthetic aspects of robot-assisted surgery (a review)

Богданов

Khusaenova

Husaenova

et al. 2023

Tihookeanskij medicinskij žurnal

View full text Add to dashboard Cite

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“…Можно говорить о более «стабильном гемодинамическом профиле» у пациентов группы исследования на таких сложных этапах оперативного вмешательства, как создание карбоксиперитонеума и приведение пациента в положение Тренделенбурга [19][20][21][22].…”

Section: результаты и обсуждениеunclassified

Correction of the Elevated Blood Pressure in Patients Undergoing Robot-Assisted Radical Prostatectomy

Kazakov

Колонтарев

Gorelova

et al. 2022

Obŝaâ reanimatologiâ

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The aim of the study was to evaluate the role of urapidil hydrochloride for the management of abnormal cardiovascular response in patients undergoing robot-assisted radical prostatectomy (RARP).Material and methods. The total of 93 prostate cancer patients scheduled for elective RARP were included and randomized in two groups: urapidil (n=44) and standard anesthesia control group (n=49). Urapidil was used to control the elevated blood pressure intraoperatively. Central hemodynamic monitoring was performed at 5 steps of the surgery.Results. In the control group, the step 2 of the procedure was associated with elevated mean blood pressure (by 24.3%, P=0.045) and increased total peripheral vascular resistance (by 46.6%, P=0.011) compared with step 1, while in the urapidil group no significant changes in these parameters were found. In the urapidil group, the blood pressure was lower by 20.2% (P=0.047), afterload by 36.9% (P=0.02) vs the control group values, whereas the cardiac output was higher by 22.2% (P=0.043). Placing patient in the steep Trendelenburg position (step 3) resulted in a 22.4% increase in stroke volume (P=0.38) in the control group and a 19.2% increase in stroke volume (P=0.049) in the urapidil group compared with the previous step. Cardiac output in the urapidil group was higher by 34% (P=0.002) and blood pressure and vascular resistance were lower by 24.4% (P=0.031) and 45.7% (P=0.001), respectively, vs the control group. At steps 4 and 5, gradual stabilization of the hemodynamic parameters and peripheral vascular tone with significantly smaller differences between the groups were revealed.Conclusion. Urapidil was effective for maintaining central hemodynamic parameters in patients during robotic-assisted radical prostatectomy at step 2 of the procedure, avoiding blood pressure elevation at step 3 and significantly reducing the total peripheral vascular resistance compared with the control group.

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Hemodynamic, renal and hormonal effects of lung protective ventilation during robot-assisted radical prostatectomy, analysis of secondary outcomes from a randomized controlled trial

Cited by 2 publications

References 30 publications

Anesthetic aspects of robot-assisted surgery (a review)

Anesthetic aspects of robot-assisted surgery (a review)

Correction of the Elevated Blood Pressure in Patients Undergoing Robot-Assisted Radical Prostatectomy

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