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Cardiac function during steep Trendelenburg position and CO 2 pneumoperitoneum for robotic‐assisted prostatectomy: a trans‐oesophageal Doppler probe study
Author(s) -
Falabella Andres,
MooreJeffries Earl,
Sullivan Michael J.,
Nelson Rebecca,
Lew Michael
Publication year - 2007
Publication title -
the international journal of medical robotics and computer assisted surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.556
H-Index - 53
eISSN - 1478-596X
pISSN - 1478-5951
DOI - 10.1002/rcs.165
Subject(s) - trendelenburg position , pneumoperitoneum , supine position , trendelenburg , medicine , anesthesia , stroke volume , cardiac output , stroke (engine) , mean arterial pressure , hemodynamics , blood pressure , cardiology , heart rate , surgery , laparoscopy , mechanical engineering , engineering
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.