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Lutfarakhmanov I.I.

Bashkir State Medical University

Syrchin E.Yu.

Bashkir State Medical University

Galeev I.R.

Bashkir State Medical University

Mironov P.I.

Bashkir State Medical University

Pavlov V.N.

Bashkir State Medical University

Central hemodynamic changes during robot-assisted radical prostatectomy depending on the type of anesthesia

Authors:

Lutfarakhmanov I.I., Syrchin E.Yu., Galeev I.R., Mironov P.I., Pavlov V.N.

More about the authors

Journal: Russian Journal of Anesthesiology and Reanimatology. 2020;(6): 69‑76

DOI: 10.17116/anaesthesiology202006169

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Table of contents

CENTRAL HEMODYNAMIC CHANGES DURING ROBOT-ASSISTED RADICAL PROSTATECTOMY DEPENDING ON THE TYPE OF ANESTHESIA
CENTRAL HEMODYNAMIC CHANGES DURING ROBOT-ASSISTED RADICAL PROSTATECTOMY DEPENDING ON THE TYPE OF ANESTHESIA

To cite this article:

Lutfarakhmanov II, Syrchin EYu, Galeev IR, Mironov PI, Pavlov VN. Central hemodynamic changes during robot-assisted radical prostatectomy depending on the type of anesthesia. Russian Journal of Anesthesiology and Reanimatology. 2020;(6):69‑76. (In Russ.)
https://doi.org/10.17116/anaesthesiology202006169

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OBJECTIVE

To evaluate the effect of various anesthetic approaches, pneumoperitoneum and steep Trendelenburg position on central hemodynamic parameters in patients with ASA class II—III undergoing robot-assisted radical prostatectomy (RARP).

MATERIAL AND METHODS

Fifty-seven patients were included in the groups of inhalational anesthesia with sevoflurane or total intravenous anesthesia with propofol (TIVA). Mean blood pressure (MBP), heart rate (HR), cardiac index (CI), and systemic vascular resistance index (SVRI) were compared between both groups before induction of anesthesia (T1), after tracheal intubation (T2), applying pneumoperitoneum (T3), transferring the patient to Trendelenburg position (T4), during dissection of dorsal venous complex (pneumoperitoneum 25 mm Hg and Trendelenburg position +30°, T5), after transferring to horizontal position (T6) and at the end of surgery (gas desufflation and tracheal extubation, T7 and T8, respectively). Between-group comparisons were made using independent Student’s t-test, within-group comparison — two-sided Bonferroni test.

RESULTS

Central hemodynamic parameters were similar in both groups, except for the time point T3, when MBP, HR and SVR were significantly lower in the TIVA group compared to the inhalational anesthesia group (p<0.01, p<0.05 and p<0.05 respectively). At the time point T4, MBP was the same, but between-group differences in HR was greater (p<0.01). There were no perioperative cardiovascular complications.

CONCLUSION

The main risk factors of perioperative hemodynamic disorders during RARP are pneumoperitoneum and steep Trendelenburg position. The type of general anesthesia is not a risk factor.

Keywords:

robot-assisted radical prostatectomy
cardiovascular system
central hemodynamics
general anesthesia

Authors:

Lutfarakhmanov I.I.

Bashkir State Medical University

Syrchin E.Yu.

Bashkir State Medical University

Galeev I.R.

Bashkir State Medical University

Mironov P.I.

Bashkir State Medical University

Pavlov V.N.

Bashkir State Medical University

Received:

08.06.2020

Accepted:

24.07.2020

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