Changes of Cerebral Blood Volume During Robot-Assisted Laparoscopic Radical Prostatectomy: Observational Prospective Study Using Near-Infrared Time-Resolved Spectroscopy

Tanaka, Nobuhiro; Yamamoto, Misazō; Abe, Takashige; Osawa, Takahiro; Matsumoto, Ryuji; Shinohara, Nobuo; Saitô, Hitoshi; Uchida, Yoshiyuki; Morimoto, Yuji

doi:10.1089/end.2019.0217

Cited by 12 publications

(14 citation statements)

References 26 publications

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“…Previous study measured cerebral blood volume using near-infrared time-resolved spectroscopy. Cerebral blood volume increased to near 10% during head down tilt position compared to the supine position [ 22 ]. Our study showed changes in rSO 2 over time, with a tendency to increase in both groups.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the effects of normal and low blood pressure regulation on the optic nerve sheath diameter in robot assisted laparoscopic radical prostatectomy

et al. 2021

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Background: Robot-assisted laparoscopic radical prostatectomy is an advanced and popular surgical technique. However, increased intracranial pressure which is caused by CO2 pneumoperitoneum and Trendelenburg position is the main cerebrovascular effect. Measurement of optic nerve sheath diameter using ocular ultrasound is a noninvasive and reliable method for the assessment of intracranial pressure. The primary endpoint of this study was to identify whether low blood pressure regulation has any benefit in attenuating an increase of optic nerve sheath diameter during robot-assisted laparoscopic radical prostatectomy.Methods: Optic nerve sheath diameter and cerebral oxygen saturation were measured at baseline (supine position), one and two hours after pneumoperitoneum and Trendelenburg position respectively, and after return to supine position in normal (n = 27) and low blood pressure groups (n = 24).Results: Mean optic nerve sheath diameter values measured at one and two hours after pneumoperitoneum and Trendelenburg position were significantly increased compared to the baseline value (P < 0.001 in normal blood pressure group; P = 0.003 in low blood pressure group). However, the mean optic nerve sheath diameter and cerebral oxygen saturation measured at any of the time points as well as degrees of change between the two groups did not show any significant changes. The peak values of optic nerve sheath diameter in normal and low blood pressure groups demonstrated 14.9% and 9.2% increases, respectively.Conclusions: Low blood pressure group demonstrated an effect in maintaining an increase of optic nerve sheath diameter less than 10% during CO2 pneumoperitoneum and Trendelenburg position.

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Section: Discussionmentioning

confidence: 99%

Comparison of the effects of normal and low blood pressure regulation on the optic nerve sheath diameter in robot assisted laparoscopic radical prostatectomy

et al. 2021

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“…Values were recorded at the following 9 time points: [1] awake patients in OR (T 1 ); [2] approximately 5 minutes after induction anesthesia and intubation (T 2 ); [3] before incision (T 3 ); [4][5][6][7] approximately 5 minutes after pneumoperitoneum and the head-down tilt (T 4 ) and 20 (T 5 ), 40 (T 6 ), and 60 (T 7 ) minutes after head-down tilt; [8] at the end of pneumoperitoneum and return to the horizontal position (T 8 ); and [9] at the end of surgery (T 9 ).…”

Section: Anesthesia Proceduresmentioning

confidence: 99%

“…Recently, a few studies have reported the simultaneous monitoring of cerebral perfusion during laparoscopic surgery with head-up or head-down tilt (4). However, these studies recruited healthy patients [American Society of Anesthesiologists (ASA) Physical status 1-2] or excluded patients with cerebral disease.…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic changes of anesthesia, pneumoperitoneum, and head-down tilt during laparoscopic surgery in elderly patients

Dong-yuan

et al. 2021

Ann Transl Med

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Background: The hemodynamic variations of cardiac and cerebral blood monitoring during pneumoperitoneum and head-down tilt position in general anesthetized elderly patients remain unresolved.We evaluated the time course of cerebral tissue oxygen saturation (SctO 2 ) and cardiac output (CO) and investigated how the changes in hemodynamic values during the surgery would affect cerebral perfusion in elderly patients. Methods: In this prospective observational study of 47 elderly patients (≥65 years old, American Society of Anesthesiologists Physical status I to III) undergoing laparoscopic colorectal radical resection with headdown position, SctO 2 by near-infrared spectroscopy and arterial pressure-based cardiac output (APCO), Cardiac index (CI), stroke volume (SV), and SV index (SVI) according to FloTrac/Vigileo were measured at 9 time points. Heart rate (HR), mean arterial blood pressure (MAP), end-tidal carbon dioxide (ETCO 2 ), bispectral index (BIS), central venous pressure (CVP), and ventilator settings were recorded. Results are reported as medians [95% confidence interval (CI)]. Results: Heart Rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), MAP, CO, CI, SV, SVI, and SctO 2 before incision decreased significantly compared with the waking state (P<0.05). SBP, CO, CI, SV, and SVI before incision decreased significantly compared with induction and intubation (P<0.05). SBP, DBP, MAP, and CVP increased significantly after pneumoperitoneum and head-down tilt, and then decreased during the following hour. CO and SVI decreased, while CI and SV increased after pneumoperitoneum and head-down tilt. CO, CI, SV and SVI decreased at the following 20, 40, and 60 minutes respectively. SctO 2 increased after pneumoperitoneum and head-down tilt and remained stable during the following hour. CVP decreased while CO, CI, SV, and SVI increased significantly at the end of pneumoperitoneum and head-down tilt (P<0.05). HR and MAP increased significantly at the end of surgery compared to at the end of pneumoperitoneum and head-down tilt (P<0.05). CI was associated with SctO 2 as indicated by a Pearson r of 0.035 (P<0.05).Conclusions: Anesthesia, pneumoperitoneum, and head-down tilt affect cardiac function and cerebral perfusion in elderly patients. cardiac index independently affects elderly patients' cerebral blood flow.

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“…The TRS method is considered to be superior to the conventional NIRS that adopts the MBL and SRS methods in regard to the correctness and reproducibility of the measured data 12 ,. 13 Moreover, in the TRS method, the absolute tHb values can be obtained, unlike with the MBL and SRS methods. The oximeter with TRS method has already been applied to robot‐assisted laparoscopic surgery, 13 parturition, 14 and cesarean section 15 and good results were obtained.…”

Section: Introductionmentioning

confidence: 99%

“… 13 Moreover, in the TRS method, the absolute tHb values can be obtained, unlike with the MBL and SRS methods. The oximeter with TRS method has already been applied to robot‐assisted laparoscopic surgery, 13 parturition, 14 and cesarean section 15 and good results were obtained. However, detailed analyses of factors such as minute diachronic changes in ScO 2 and tHb were not done in the cesarean section study.…”

Section: Introductionmentioning

confidence: 99%

Changes of cerebral oxygenation indices measured by near infrared time‐resolved spectroscopy during spinal anesthesia for cesarean section: Simultaneous measurement with cerebral blood flow

Itosu

Kubo

Morikawa

et al. 2021

J of Obstet and Gynaecol

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Aim To measure the changes in cerebral oxygenation indices by near infrared time‐resolved spectroscopy and the cerebral blood flow simultaneously after spinal anesthesia for cesarean section. Methods This prospective observational study was conducted for 25 pregnant women scheduled for elective cesarean section under spinal anesthesia. During a period of 15 min after spinal anesthesia, cerebral oxygenation (ScO2), and the total cerebral hemoglobin concentration (tHb) were measured using near infrared time‐resolved spectroscopy and mean cerebral blood flow velocity (Vm) was measured using transcranial Doppler ultrasonography. Next, in the women who had nausea during the observed period, we compared these values when nausea was detected with those when it was not. Results Mean arterial pressure (MAP) decreased to around 60 mmHg (by 25% compared to the control) 6 min after spinal anesthesia. Compared to the control, ScO2 decreased by about 3% after 6 min and then gradually increased. The tHb, which reflects cerebral blood volume started to decrease just after spinal anesthesia and this continued until 12 min (the decrease was about 12%). Vm decreased by about 7%. In the 14 women who had nausea, MAP, Vm, and ScO2 values when nausea was detected were significantly lower than when it was not. Conclusion The changes in cerebral hemodynamics may be small after spinal anesthesia in ordinary cesarean section compared to the reduction of systemic arterial blood pressure. There might be greater decreases in cerebral blood flow and oxygenation when nausea occurred in the pregnant women who experienced it after spinal anesthesia.

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Changes of Cerebral Blood Volume During Robot-Assisted Laparoscopic Radical Prostatectomy: Observational Prospective Study Using Near-Infrared Time-Resolved Spectroscopy

Cited by 12 publications

References 26 publications

Comparison of the effects of normal and low blood pressure regulation on the optic nerve sheath diameter in robot assisted laparoscopic radical prostatectomy

Comparison of the effects of normal and low blood pressure regulation on the optic nerve sheath diameter in robot assisted laparoscopic radical prostatectomy

Hemodynamic changes of anesthesia, pneumoperitoneum, and head-down tilt during laparoscopic surgery in elderly patients

Changes of cerebral oxygenation indices measured by near infrared time‐resolved spectroscopy during spinal anesthesia for cesarean section: Simultaneous measurement with cerebral blood flow

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