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

Lee, Hee Jong; Kim, Kyo Sang; Shim, Jae Chul; Cha, Dong Guk; Jeong, Ji Seon

Clinical Research

Neuromuscular Physiology and Pharmacology

Anesthesia and Pain Medicine 2012;7(3):249-255.
Published online July 31, 2012.

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

Hee Jong Lee, Kyo Sang Kim, Jae Chul Shim, Dong Guk Cha, Ji Seon Jeong

Department of Anesthesiology and Pain Medicine, Hanyang University Hospital, Seoul, Korea. kimks@hanyang.ac.kr

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.

Key Words: Cardiac diseases, Elderly, Hemodynamics, Robot-assisted laparoscopic prostatectomy