Effects of carbon dioxide pneumoperitoneum and steep Trendelenburg positioning on cerebral blood backflow during robotic radical prostatectomy
DING Lingling
ZHANG Hong
MI Weidong
SUN Li
ZHANG Xu
MA Xin
LI Hongzhao
Abstract：Objective To observe the effect of carbon dioxide pneumoperitoneum and Trendelenburg position on cerebral blood backflow during robot-assisted radical prostatectomy in elderly patients. Methods Fifty elderly patients (65-80 years) and 50 middle-aged patients (45-64 years) undergoing elective robot-assisted prostatectomy were enrolled in this study. For all the patients, jugular bulb and arterial blood gas was monitored and recorded before pneumoperitoneum (T0), 10 min after pneumoperitoneum was achieved (T1), 10 min (T2) and 60 min (T3) after Trendelenberg position, and 10 min in supine position after termination of pneumoperitoneum (T4). Results Compared with those at T0, the mean arterial pressure, heart rate, and BIS value at T1, T2, T3 and T4 all showed no significant variations (P>0.05), but rSO2, SjvO2, and JBP increased significantly in both groups (P<0.01). Compared with those in the middle-aged group, rSO2, SjvO2, and JBP increased significantly and Da-jO2 decreased at T2, T3 in the elderly group (P<0.01), but jugular vein blood glucose or lactic acid content showed no significant difference between the two groups (P>0.05). Conclusion Pneumoperitoneum and Trendelenburg position cause more obvious cerebral blood backflow in elderly patients than in middle-aged patients but do not affect cerebral metabolism of oxygen.
Keywords：robot-assisted radical prostatectomypneumoperitoneumsteep Trendelenburg positioncerebral blood flow
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 712-715 )