Anesthesia for Robotic Surgery

Goswami, Sumeet; Nishanian, Ervant; Mets, Berend

doi:10.1016/b978-0-443-06959-8.00076-5

Cited by 9 publications

(17 citation statements)

References 81 publications

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“…The advantages of this surgery are a small incision, 3-dimensional visualisation, minimal blood loss, low levels of postoperative pain and a short hospital stay [1,2]. However, there are conditions which can pose a risk in the application of anaesthesia such as cardiovascular (an increase in central venous pressure, pulmonary artery and pulmonary capillary pressury or severe bradycardia) and pulmonary (an increase in peak airway pressure, plateau pressure and decreased pulmonary compliance) changes created by the steep Trendelenburg position and pneumoperitoneum [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…However, there are conditions which can pose a risk in the application of anaesthesia such as cardiovascular (an increase in central venous pressure, pulmonary artery and pulmonary capillary pressury or severe bradycardia) and pulmonary (an increase in peak airway pressure, plateau pressure and decreased pulmonary compliance) changes created by the steep Trendelenburg position and pneumoperitoneum [3][4][5]. Also there are circumstances such as, hypothermia and venous gas embolism or subcutaneous emphysema [1,2].…”

Section: Introductionmentioning

confidence: 99%

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The Effects Of Nitrous Oxide On Postoperative Pain, Nausea Vomiting and Intraoperative Haemodynamics in Robotic Gynecologic Surgery

Yanli¹

2017

SDRP-JAS

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BACKGROUND n recent years there has been an increase in gynaecological operations performed with robotic surgery. In these procedures, nitrous oxide(N 2 O) or air are used together with inhalation anaesthestics. In this study we aimed to compare the effects of O 2 /N 2 O or O 2 /Air on postoperative pain, nausea vomiting (PONV) and intraoperative thermodynamics in robotic surgery. METHODSAged 28-71 years, classified ASA I-II, 58 patients were separated into 2 groups. Following induction, anaesthesia was maintained O 2 /Air (Group A) or O 2 /N 2 O (Group N) with sevoflurane. Heart rate (HR), mean arterial pressure (MAP), Central Venous Pressure (CVP), end tidal carbon dioxide (ETCO 2 ), peripheral oxygen saturation (SpO 2 ), Aldrete recovery score (ARS), postoperative nausea and vomiting (PONV) and visual analog scale (VAS) were recorded during the operation and postoperative period. RESULTSThe VAS values were higher in Group N at 5th min and higher in Group A at 150th min (p<0.05). In the intragroup analysis, VAS values were significantly lower at 120th, 150th, 180th min compared with 5th, 15th, 30th and 60th min in Group N (p<0.05). In Group A, the values at 15th, 30th min was significantly higher than 60th, 120th and 180th min (p<0.05). Intraoperative haemodynamic parameters (HR, MAP, CVP) were similar in two groups (p>0.05). Intragroup analysis of PONV values were significantly lower at 150th and 180th min compared with both 5th and 30th min in Group N and significantly higher at 5th min compared with 180th min in GroupA(p<0.05). CONCLUSIONWith regard to acute postoperative analgesia we could not find any significant difference between N 2 O and air. Further clinical studies are required to investigate this subject in respect of differences (at 5th min and at 150th min) in the VAS scores.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Effects Of Nitrous Oxide On Postoperative Pain, Nausea Vomiting and Intraoperative Haemodynamics in Robotic Gynecologic Surgery

Yanli¹

2017

SDRP-JAS

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“…A anestesia e a cirurgia foram evoluindo e os cuidados com os pacientes foram se modificando, tornando mais eficientes, mas novos desafios foram sendo impostos ao anestesista para o cuidado adequado ao paciente (8,16) .…”

Section: A Evolução Da Anestesiaunclassified

“…O uso do robô em cirurgia urológica tem aumentado com o passar do tempo, neste caso destacamos principalmente avanços na prostatectomia radical robótica, para tratamento do CaP (8,26) .…”

Section: A Cirurgia Robóticaunclassified

“…A cirurgia robótica possui vantagens em relação à laparoscopia, como por exemplo, as pinças têm sete graus de liberdade (inserção, rotação e movimentação no eixo x e y fora dor corpo relacionado ao ponto de apoio na parede abdominal e articulações intracorporais da pinça e apreensão) de movimentos imitando os movimentos da mão do ser humano e filtro de tremor (8) .…”

Section: A Cirurgia Robóticaunclassified

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O uso de Dexmedetomidina pode diminuir a dor pós-operatória em pacientes submetidos a prostatectomia radical robótica?

Quinto¹

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AGRADECIMENTOSAgradeço aos que me acompanharam nesta trajetória e com seu conhecimento, compreensão, amizade, competência, para que esta tese fosse possível e se tornasse realidade, ao Professor Dr. Miguel Srougi, Professor Dr. Homero Bruschini e Professor Dr. Alberto Azoubel Antunes.Ao meu orientador Professor Dr. Carlo Camargo Passerotti, pela orientação, ensinamento, confiança e competência.A Sabrina Reis, pela amizade, paciência e ajuda. ,25% e 15,4% had more than 5mg of morphine on postoperative care unit), patients that received DEX intraoperatively, required higher doses of morphine on postoperative care unit.The DEX group presented more patients with severe pain (84,6%) and fewer without pain(15,4%).The use of DEX intraoperatively lead to a reduction of non-opioid use in postanesthesia care unit and neither patients had non opioid analgesia , when morphine is associated to DEX 2,8% received, and with the other two groups 12,5% (p=0,083). The DEX and morphine received less morphine than the other groups on postanesthesia care unit (59% received any morphine)(p=0,135).On immediate postoperative period and first postoperative period , 100% received any morphine(p=0,555), this group had more patients with lesser pain, 48,7% had no pain on postanesthesia care unit e 51,3% on immediate postoperative period. The combination of DEX and morphine lead to an impressive reduction of pain on immediate postoperative period(10,3%),patients had about 8 times less severe pain than the group that did not receive neither morphine or DEX(81,3%)(p=0,000).Conclusion: The use of DEX infusion was not suitable regarding morphine spare and reduction of pain of the patients undergoing robotic-assisted radical prostatectomy. An association between DEX and Morphine seems to be the best option to relieve post-op pain and decrease morphine usage. Normatização

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