Anesthesia for Radical Prostatectomy, Cystectomy, Nephrectomy, Pheochromocytoma, and Laparoscopic Procedures

Whalley, David G.; Berrigan, Michael J.

doi:10.1016/s0889-8537(05)70201-7

Cited by 19 publications

(6 citation statements)

References 76 publications

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“…Normal gradient between EtCO 2 and PaCO 2 is 5-10 mmHg, which increases during laparoscopic surgery in Trendelenburg position due to continuous insufflation of CO 2 , V/P mismatch and reduced functional residual capacity leading to potential atelectasis. [9] Kalmar et al . [2] observed that there is a stronger underestimation of the true carboxaemia at higher levels of EtCO 2 in patients undergoing robotic prostatectomy in steep Trendelenburg position, Klopfenstein et al .…”

Section: Discussionmentioning

confidence: 99%

Anaesthesia for laparoscopic kidney transplantation: Influence of Trendelenburg position and CO ₂ pneumoperitoneum on cardiovascular, respiratory and renal function

Parikh¹,

Shah²,

Modi

et al. 2013

Indian J Anaesth

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Background:Laparoscopic donor nephrectomy is a routine practice since 1995. Until now, the recipient has always undergone open surgery for transplantation. In our institute, laparoscopic kidney transplantation (LKT) started in 2010. To facilitate this surgery, the patient must be in steep Trendelenburg position for a long duration. Hence, we decided to study the effect of CO2 pnuemoperitoneum and Trendelenburg position in chronic renal failure (CRF) patients undergoing LKT.Methods:A total of 20 adult CRF patients having mean age of 31.7±10.36 years and body mass index 19.65±3.41 kg/m2 without significant coronary artery disease were selected for the procedure. Cardiovascular parameters heart rate (HR), mean arterial pressure (MAP), Central venous pressure (CVP) and respiratory parameters (ETCO2, peak airway pressure) were noted at the time of induction, after induction, 15 min after creation of pnuemoperitoneum, 30 min after Trendelenburg position, 15 min after decompression of pnuemoperitonuem and after extubation. Arterial blood gas analysis was carried out after induction, 15 min after creation of pnuemoperitoneum, 30 min after Trendelenburg position and 15 min after clamp release. Total duration of surgery, anastomosis time, time for the establishment of urine output and total urine output were noted. Serum creatinine on the 1st and 7th post-operative day were recorded.Results:Significant increase in HR was observed after creation of CO2 pneumoperitoneum and just before extubation. Significant increase in the MAP and CVP was noted after creation of pneumoperitoneum and after giving Trendelenburg position. No significant rise in the ETCO2 and PaCO2 was observed. Significant increase in the base deficit was observed after the clamp release, but none of the patients required correction.Conclusion:LKT performed in steep Trendelenburg position with CO2 pneumoperitoneum significantly influenced cardiovascular and respiratory homeostasis; however, measured parameters remained within clinically acceptable range without affecting early function of the transplanted kidney.

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Section: Discussionmentioning

confidence: 99%

Anaesthesia for laparoscopic kidney transplantation: Influence of Trendelenburg position and CO ₂ pneumoperitoneum on cardiovascular, respiratory and renal function

Parikh¹,

Shah²,

Modi

et al. 2013

Indian J Anaesth

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“…Although regional anesthesia has been applied successfully for laparoscopic cholecystectomy [12], general anesthesia is thought to be the technique of choice for laparoscopic procedures [13]. The combination of a generally uncomfortable position on the operating table together with a long-lasting procedure makes a state of wakefulness during laparoscopic surgery not very acceptable for patients.…”

Section: Anesthetic Techniquementioning

confidence: 99%

Laparoscopic surgery: Pitfalls due to anesthesia, positioning, and pneumoperitoneum

Henny

Hofland

2005

Surg Endosc

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“…Esmolol, propanolol, or lidocaine may be useful to manage these dysrhythmias, but caution in their administration is advised in patients with severe ventricular dysfunction. Labetalol may also be useful for pheochromocytomas that predominantly secrete epinephrine 16.…”

Section: Perioperative Considerations With Pheochromocytomamentioning

confidence: 99%

Perioperative considerations in patients with adrenal tumors

Phitayakorn

McHenry

2012

Journal of Surgical Oncology

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In this article the pre-operative, intraoperative, and post-operative management of patients with pheochromocytoma, aldosterone-producing adenoma, cortisol-producing tumors, and adrenal cortical carcinoma are reviewed. A detailed plan for pre-operative assessment and medical optimization is discussed. The potential intraoperative and post-operative complications that occur in patients with an adrenal tumor are reviewed with emphasis on recognition, treatment and prevention. Recommendations for anesthetic management, intraoperative and post-operative monitoring, blood pressure management, laboratory analysis and medication adjustments are presented.

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Anesthesia for Radical Prostatectomy, Cystectomy, Nephrectomy, Pheochromocytoma, and Laparoscopic Procedures

Cited by 19 publications

References 76 publications

Anaesthesia for laparoscopic kidney transplantation: Influence of Trendelenburg position and CO ₂ pneumoperitoneum on cardiovascular, respiratory and renal function

Anaesthesia for laparoscopic kidney transplantation: Influence of Trendelenburg position and CO ₂ pneumoperitoneum on cardiovascular, respiratory and renal function

Laparoscopic surgery: Pitfalls due to anesthesia, positioning, and pneumoperitoneum

Perioperative considerations in patients with adrenal tumors

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Anesthesia for Radical Prostatectomy, Cystectomy, Nephrectomy, Pheochromocytoma, and Laparoscopic Procedures

Cited by 19 publications

References 76 publications

Anaesthesia for laparoscopic kidney transplantation: Influence of Trendelenburg position and CO 2 pneumoperitoneum on cardiovascular, respiratory and renal function

Anaesthesia for laparoscopic kidney transplantation: Influence of Trendelenburg position and CO 2 pneumoperitoneum on cardiovascular, respiratory and renal function

Laparoscopic surgery: Pitfalls due to anesthesia, positioning, and pneumoperitoneum

Perioperative considerations in patients with adrenal tumors

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Anaesthesia for laparoscopic kidney transplantation: Influence of Trendelenburg position and CO ₂ pneumoperitoneum on cardiovascular, respiratory and renal function

Anaesthesia for laparoscopic kidney transplantation: Influence of Trendelenburg position and CO ₂ pneumoperitoneum on cardiovascular, respiratory and renal function