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Changes in cardiac function and hemodynamics during robot-assisted laparoscopic prostatectomy with steep head-down tilt: a prospective observational study
OBJECTIVE: Robot-assisted laparoscopic prostatectomy requires the patient to be placed in a steep head-down tilt. The aim of our study was to investigate changes in cardiac index and left ventricular end-diastolic volume in a steep had-down tilt. This is a prospective observational study. We investi...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5534046/ https://www.ncbi.nlm.nih.gov/pubmed/28754145 http://dx.doi.org/10.1186/s13104-017-2672-z |
Sumario: | OBJECTIVE: Robot-assisted laparoscopic prostatectomy requires the patient to be placed in a steep head-down tilt. The aim of our study was to investigate changes in cardiac index and left ventricular end-diastolic volume in a steep had-down tilt. This is a prospective observational study. We investigated the influence of steep head-down tilt on cardiac function and hemodynamics without fluid restriction in 12 men of American Society of Anesthesiologists physical status I–II undergoing robot-assisted laparoscopic prostatectomy. We measured left ventricular ejection fraction, left ventricular end-diastolic volume and cardiac index by transesophageal echocardiography, cardiac index using a FloTrac(®) sensor, heart rate and arterial blood pressure, before and 5 min after tilting the operating table. RESULTS: The following variables changed significantly after tilting and establishment of the pneumoperitoneum: left ventricular ejection fraction (before 62.5%, after 55.5%; P = 0.040), systolic blood pressure (before 116 mmHg, after 128 mmHg; P = 0.001) and diastolic blood pressure (before 59 mmHg, after 70 mmHg; P = 0.002). There were no significant changes in cardiac index or left ventricular end-diastolic volume measured by transesophageal echocardiography, or cardiac index by FloTrac(®) sensor. Left ventricular ejection fraction decreased, whereas cardiac index and left ventricular end-diastolic volume did not change, indicating that steep head-down tilt and pneumoperitoneum during robot-assisted laparoscopic prostatectomy did not greatly influence cardiac function. This study was registered as a clinical study with the Japanese Official Clinical Trial Registry (Trial Registration Number JMA-IIA00158 on 7th January, 2014) |
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