Lower limb perfusion during robotic-assisted laparoscopic radical prostatectomy evaluated by near-infrared spectroscopy: an observational prospective study.
Lower limb perfusion during robotic-assisted laparoscopic radical prostatectomy evaluated by near-infrared spectroscopy: an observational prospective study.
复制标题
DOI：
10.1186/s12871-018-0567-8
复制
发表时间：
2018-08-18
影响因子：
2.2
通讯作者：
Yorozuya T
中科院分区：
文献类型：
--
作者：
Takechi K;Kitamura S;Shimizu I;Yorozuya T
在手术中，将患者置于切开取石位或Trendelenburg体位会产生几种不良反应，其中之一就是下肢血流灌注减少。本研究旨在应用近红外光谱(NIRS)技术评价机器人辅助下腹腔镜行前列腺癌根治术(RARP)时患者体位对患者体位的影响。这项观察研究包括30名同意接受美国麻醉医师协会身体状况I级和II级(年龄范围，≥20到<； 80岁)的男性。使用INVOS™血氧仪(美国密西西比州特洛伊索马尼提)测量区域血氧饱和度。近红外传感器被放置在小腿肌肉(腓肠肌和比目鱼肌)干中部区域的皮肤表面上，位于右小腿后室上方。分别于麻醉前和麻醉后5min(T0、T1)、0°切开位气腹后5min(T2)、25°Trendelenburg位气腹后5min(T3)、气腹后Trendelenburg位30、60、90和120min(分别为T4、T5、T6和T7)、仰卧位脱气后(T8)和拔管后(T9)采集局部血氧饱和度(RSO2)。无患肢间室综合征风险的RARP患者麻醉诱导后肢体血流灌注增加并维持在陡峭的Trendelenburg位(T0：65 ± 7.2%，T1：69 ± 6.1%，T2：70±6.1%，T3：68 ± 6.7%，T4：66 ± 7.5%，T5：67 ± 6.9%，T6：68 ± 7.2%，T8：73 ± 7.2%，T9：71 ± 7.9%，分别)。在RARP过程中，NIRS评估的下肢血流灌注率维持不变。正确的患者体位和对血管发病率等危险因素的仔细评估对于预防RARP中的LLCS可能很重要。
Decreased perfusion in the lower extremities is one of the several adverse effects of placing patients in a lithotomy or Trendelenburg position during surgery. This study aimed to evaluate the effects of patient positioning in lower limb perfusion patients undergoing robotic-assisted laparoscopic radical prostatectomy (RARP) using near-infrared spectroscopy (NIRS). This observation study comprised 30 consenting males with American Society of Anaesthesiologists physical status classes I and II (age range, ≥20 to < 80 years). Regional saturation of oxygen measurements was obtained using an INVOS™ oximeter (Somanetics, Troy, MI, USA). A NIRS sensor was positioned on the surface of the skin at the mid-diaphyseal region of the calf muscles (the gastrocnemius and soleus), over the posterior compartment, in the right lower leg. Regional saturation of oxygen (rSO2) was sampled during the following time points: before and 5 min after induction of anaesthesia (T0,T1); 5 min after establishment of pneumoperitoneum in a 0° lithotomy position (T2); 5 min after a 25° Trendelenburg position (T3); 30, 60, 90 and 120 min after pneumoperitoneum in a Trendelenburg position (T4, T5, T6 and T7, respectively); after desufflation in a supine position (T8); and after tracheal extubation (T9). Lower limb perfusion evaluated by NIRS was increased after induction of anaesthesia and maintained during steep Trendelenburg positions in RARP patients with no risk for lower limb compartment syndrome (LLCS) (T0:65 ± 7.2%, T1:69 ± 6.1%, T2:70±:6.1%, T3:68 ± 6.7%, T4:66 ± 7.5%, T5:67 ± 6.9%, T6:68 ± 7.2%, T8:73 ± 7.2%, T9:71 ± 7.9%, respectively). Lower limb perfusion evaluated by NIRS was maintained during the RARP procedure. Correct patient positioning and careful assessment of risk factors such as vascular morbidity could be important for the prevention of LLCS during RARP.
登录
查看更多内容
影响因子：
4.5
作者：
Mumtaz, FH;Chew, H;Gelister, JS
通讯作者：
Gelister, JS
影响因子：
9.8
作者：
Murkin, J M;Arango, M
通讯作者：
Arango, M
影响因子：
9.8
作者：
De Blasi, R. A.;Palmisani, S.;Pinto, G.
通讯作者：
Pinto, G.
DOI：
10.2106/00004623-200210000-00014
发表时间：
2002-10-01
影响因子：
5.3
作者：
Meyer, RS;White, KK;Hargens, AR
通讯作者：
Hargens, AR
DOI：
10.1177/1089253209353134
发表时间：
2009-12-01
影响因子：
1.4
作者：
Turek, Zdenek;Sykora, Roman;Cerny, Vladimir
通讯作者：
Cerny, Vladimir