The Impact of Abdominal Insufflation on the Intraocular Pressure During Robot-Assisted Radical Prostatectomy.

IF 2.8 2区医学 Q1 UROLOGY & NEPHROLOGY Journal of endourology Pub Date : 2025-02-10 DOI:10.1089/end.2024.0509

Amir Khan, Shu Wang, Osamah Saeedi, Amanda Ryan, Mohummad Minhaj Siddiqui

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Abstract

Introduction and objective: Increased intraocular pressure (IOP) during robot-assisted radical prostatectomy (RARP) is known to occur and may cause in rare cases anterior ischemic optic neuropathy. In this study, we evaluated the impact of abdominal insufflation pressures on IOP during RARP in a cohort of patients undergoing RARP.

Methods: Patients undergoing RARP were recruited for this Institutional Review Board-approved study from January 2019 to October 2022 at our Center. IOP was measured for both eyes using a Tonopen (Reichert, Buffalo, NY) at six time points (T1-T6); preoperatively, in the operating room in supine position under anesthesia without insufflation, at 30^ο Trendelenburg position (T position) without insufflation, at Trendelenburg position with abdominal insufflation at 10 mm Hg, 15 mm Hg, and 20 mm Hg. A mixed effects model was applied to analyze changes in IOP with changes in insufflation pressure, while controlling for age, body mass index (BMI), and systolic blood pressure.

Results: For a total of 28 patients, the mean age and BMI were 61.2 ± 7.4 (SD) years, and 29.0 ± 4.6 kg/m², respectively, while the mean systolic blood pressure was 128.1 mm Hg ± 17.0 mm Hg. The mean IOP at six time points increased from 13.6 mm Hg to 26.8 mm Hg, whereas the mean systolic blood pressure ranged from 132.1 (±17) mm Hg to 130.9 (±18) mm Hg from time points 1-6. On a mixed-effects model, a change in 1 mm Hg of abdominal insufflation pressures was associated with a 0.35 mm Hg increase in IOP (95% confidence interval [CI] = 0.29-0.4) holding all other variables constant. Furthermore, a 1 mm Hg change in systolic blood pressure was associated with a 0.06 mm Hg increase in IOP (95% CI = 0.03-0.09).

Conclusion: Our findings suggest that intra-abdominal insufflation pressure and systolic blood pressure are significantly associated with IOP during RARP after accounting for the correlation of the repeated measures and controlling for age and BMI.

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机器人辅助前列腺根治术中腹腔充气对眼压的影响。

简介与目的：在机器人辅助根治性前列腺切除术（RARP）过程中，眼压（IOP）升高是已知的，并可能导致罕见的前缺血性视神经病变。在这项研究中，我们评估了一组接受RARP的患者在RARP期间腹部充气压力对IOP的影响。方法：2019年1月至2022年10月，在我们的中心招募了接受RARP治疗的患者。使用Tonopen （Reichert, Buffalo， NY）在6个时间点（T1-T6）测量双眼IOP；术前，在手术室内，麻醉下仰卧位不充气，30o Trendelenburg体位（T位）不充气，Trendelenburg体位腹部充气在10 mm Hg、15 mm Hg和20 mm Hg。在控制年龄、体重指数（BMI）和收缩压的情况下，应用混合效应模型分析IOP随充气压力变化的变化。结果：28例患者平均年龄为61.2±7.4 （SD）岁，BMI为29.0±4.6 kg/m2，平均收缩压为128.1 mm Hg±17.0 mm Hg， 6个时间点平均IOP从13.6 mm Hg升高到26.8 mm Hg，平均收缩压从132.1（±17）mm Hg升高到130.9（±18）mm Hg。在混合效应模型中，在所有其他变量不变的情况下，腹部充气压力每改变1 mm Hg， IOP升高0.35 mm Hg（95%可信区间[CI] = 0.29-0.4）。此外，收缩压变化1 mm Hg与IOP升高0.06 mm Hg相关（95% CI = 0.03-0.09）。结论：我们的研究结果表明，在考虑重复测量的相关性并控制年龄和BMI后，RARP期间腹内充气压和收缩压与IOP显著相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of endourology 医学-泌尿学与肾脏学

CiteScore

5.50

自引率

14.80%

发文量

254

审稿时长

1 months

期刊介绍： Journal of Endourology, JE Case Reports, and Videourology are the leading peer-reviewed journal, case reports publication, and innovative videojournal companion covering all aspects of minimally invasive urology research, applications, and clinical outcomes. The leading journal of minimally invasive urology for over 30 years, Journal of Endourology is the essential publication for practicing surgeons who want to keep up with the latest surgical technologies in endoscopic, laparoscopic, robotic, and image-guided procedures as they apply to benign and malignant diseases of the genitourinary tract. This flagship journal includes the companion videojournal Videourology™ with every subscription. While Journal of Endourology remains focused on publishing rigorously peer reviewed articles, Videourology accepts original videos containing material that has not been reported elsewhere, except in the form of an abstract or a conference presentation. Journal of Endourology coverage includes: The latest laparoscopic, robotic, endoscopic, and image-guided techniques for treating both benign and malignant conditions Pioneering research articles Controversial cases in endourology Techniques in endourology with accompanying videos Reviews and epochs in endourology Endourology survey section of endourology relevant manuscripts published in other journals.