Anesth Pain Med.  2012 Jul;7(3):249-255.

Hemodynamic parameters during robotic radical prostatectomy in elderly patients with increased cardiac risk

• Lee HJ
• Kim KS
• Shim JC
• Cha DG
• Jeong JS

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.

Keyword

Cardiac diseases; Elderly; Hemodynamics; Robot-assisted laparoscopic prostatectomy

MeSH Terms

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