Effects of Bowel Preparation and Fluid Restriction in Robot-Assisted Radical Prostatectomy Patients

Karaören, Gülşah; Bakan, Nurten; Yürük, Cafer Tayyar; Çetinkaya, Ali

doi:10.5152/tjar.2014.57704

Cited by 2 publications

(2 citation statements)

References 16 publications

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“…In addition, STP and normo-hydration can complicate anastomosis by causing urine flow during ureterovesical anastomosis. [12] Thus, fluid restriction (normal saline [1 ml/kg/h] and 6% HES 200/05 [1 ml/kg/h] infusions), as we also applied in our study, is recommended RAPR in procedures in particular. However, this can cause relative hypovolaemia and decreased perfusion in compressed tissues in robotic prostatectomy procedures, resulting in increased risk for RM.…”

Section: Discussionmentioning

confidence: 93%

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Is rhabdomyolysis an anaesthetic complication in patients undergoing robot-assisted radical prostatectomy?

et al. 2017

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BACKGROUND:In patients undergoing robot-assisted radical prostatectomy (RARP), pneumoperitoneum, intraoperative fluid restriction and prolonged Trendelenburg position may cause rhabdomyolysis (RM) due to hypoperfusion in gluteal muscles and lower extremities. In this study, it was aimed to assess effects of body mass index (BMI), comorbidities, intra-operative positioning, fluid restriction and length of surgery on the development of RM in RARP patients during the perioperative period.SUBJECTS AND METHODS:The study included 52 American Society of Anesthesiologists I–II patients aged 50–80 years with BMI >25 kg/m2, who underwent RARP. Fluid therapy with normal saline (1 ml/kg/h) and 6% hydroxyethyl starch 200/05 (1 ml/kg/h) was given during the surgery. Charlson comorbidity index (CCI), operation time (OT) and Trendelenburg time (TT) were recorded. Blood samples for creatine phosphokinase (CPK), blood urea nitrogen, creatinine (Cr), aspartate aminotransferase (AST), alanine transferase (ALT), lactate dehydrogenase (LDH), creatinine kinase-MB, cardiac troponin I and arterial blood gases were drawn at baseline and on 6, 12, 24 and 48 h. RM was defined by serum CPK level exceeding 5000 IU/L.RESULTS:Seven patients met predefined criteria for RM. There were positive correlations among serum CPK and Cr, AST, ALT and LDH levels. However, there was no significant difference in BMI, OT and TT between patients with or without RM (P > 0.05). CCI scores were higher in patients with RM than those without (3.00 ± 0.58 vs. 2.07 ± 0.62; P < 0.01). No renal impairment was detected among patients with RM at the post-operative period.CONCLUSIONS:It was found that comorbid conditions are more important in the development of RM during RARP rather than BMI, OT or TT. Patients with higher comorbidity are at risk for RM development and that this should be kept in mind at follow-up and when informing patients.

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Section: Discussionmentioning

confidence: 93%

“…[512] In general, serum CPK, LDH, AST and ALT values are used in the follow-up. [16] Molecular mechanism linking hepatic dysfunction to RM has not been fully elucidated and it is considered to be multifactorial.…”

Section: Discussionmentioning

confidence: 99%

Is rhabdomyolysis an anaesthetic complication in patients undergoing robot-assisted radical prostatectomy?

et al. 2017

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The effect of different levels of pneumoperitoneum pressures on regional cerebral oxygenation during robotic assisted laparoscopic prostatectomy

Karaveli¹,

Kavakli²,

Küçük³

et al. 2021

Turk J Med Sci

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Background/aim This study aimed to evaluate the effect of low- and high-pressure pneumoperitoneum pressures applied during robotic-assisted laparoscopic prostatectomy (RALP) using near-infrared spectroscopy (NIRS) on regional cerebral oxygenation saturation (rSO 2 ). Materials and methods The prospective, comparative, and observational study included patients aged 18–80 years, with the American Society of Anesthesiologists (ASA) physical status I-II, who would undergo elective RALP. The patients were divided into two groups (12 mmHg of pneumoperitoneum pressure group, n=22 and 15 mmHg of pneumoperitoneum pressure group, n=23). Patients’ demographic data, durations of anesthesia, surgery, pneumoperitoneum, and Trendelenburg position, intraoperative estimated blood loss, fluid therapy, urine output, hemodynamic and respiratory data, and rSO 2 values were recorded at regular intervals. Results The rSO 2 values increased significantly during the pneumoperitoneum combined with steep Trendelenburg position (from t 3 to t 6 ) and at the end of the surgery ( t 7 ) in both groups, compared to the values 5 min after the onset of pneumoperitoneum in the supine position ( t 2 ) (P < 0.05), but no statistical significance was observed between the two groups. No cerebral desaturation was observed in any of our patients. Hemodynamic and respiratory parameters were preserved in both groups. The blood lactate levels were significantly higher in patients operated at high-pressure pneumoperitoneum, compared to those with low-pressure pneumoperitoneum (P < 0.05). Conclusion We believe that low-pressure pneumoperitoneum, especially in robotic surgeries, such as robotic-assisted laparoscopic prostatectomy (RALP), can be applied safely.

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Effects of Bowel Preparation and Fluid Restriction in Robot-Assisted Radical Prostatectomy Patients

Cited by 2 publications

References 16 publications

Is rhabdomyolysis an anaesthetic complication in patients undergoing robot-assisted radical prostatectomy?

Is rhabdomyolysis an anaesthetic complication in patients undergoing robot-assisted radical prostatectomy?

The effect of different levels of pneumoperitoneum pressures on regional cerebral oxygenation during robotic assisted laparoscopic prostatectomy

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