Comparison of anesthetic management and outcomes of robot-assisted versus open radical cystectomy

Terrence L. Trentman, Sharon L. Fassett, Dustin McGirr, Brad Anderson, Yu Hui H Chang, Rafael Nunez Nateras, Erik P Castle, David M. Rosenfeld

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Robot-assisted cystectomy surgery may be advantageous for patients. The purpose of this study was to compare anesthetic management and outcomes in patients undergoing robot-assisted versus open radical cystectomy. In a retrospective review of 256 cystectomy procedures, procedure duration, blood loss, respiratory parameters, recovery room opiate consumption, pain scores and antiemetic use in the recovery room, and hospital length of stay were compared. After exclusions, 96 robot-assisted and 102 open procedures were analyzed. Anesthesia and surgery duration were significantly longer in the robot-assisted group, while the length of hospital stay was significantly shorter in the robot-assisted group: 7.1 ± 5.8 versus 9.8 ± 5.03 days, p = 0.0005. Estimated blood loss was 601.8 ± 491.4 ml in the open group versus 257.7 ± 164.3 ml in the robot-assisted group, p < 0.0001. Recovery room opiate consumption was significantly less in the robot-assisted group: 9.5 ± 8.9 versus 12.6 ± 9.9 mg (morphine equivalents), p = 0.02. The highest recorded respiratory rate was significantly higher in the robot-assisted group, as was the highest recorded peak airway pressure. Among patients with arterial blood gas data, the highest arterial partial pressure of CO2 was significantly greater in the robot-assisted group than in the open surgery group: 42.6 ± 5.6 versus 37.4 ± 4.8 mmHg CO2, p = 0.0001. Surgeons and anesthesia providers can expect robot-assisted radical cystectomy surgery to last longer than traditional open surgery, but to be associated with less pain and blood loss. Positioning and abdominal insufflation for robot-assisted surgery may contribute to ventilation challenges.

Original languageEnglish (US)
Pages (from-to)273-279
Number of pages7
JournalJournal of Robotic Surgery
Volume7
Issue number3
DOIs
StatePublished - Sep 2013

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Cystectomy
Anesthetics
Recovery Room
Opiate Alkaloids
Length of Stay
Anesthesia
Pain
Insufflation
Antiemetics
Partial Pressure
Respiratory Rate
Morphine
Ventilation
Arterial Pressure
Gases
Pressure

Keywords

  • Cystectomy
  • Opiates
  • Robot
  • Robotic surgery
  • Trendelenburg

ASJC Scopus subject areas

  • Surgery
  • Health Informatics

Cite this

Trentman, T. L., Fassett, S. L., McGirr, D., Anderson, B., Chang, Y. H. H., Nateras, R. N., ... Rosenfeld, D. M. (2013). Comparison of anesthetic management and outcomes of robot-assisted versus open radical cystectomy. Journal of Robotic Surgery, 7(3), 273-279. https://doi.org/10.1007/s11701-012-0379-7

Comparison of anesthetic management and outcomes of robot-assisted versus open radical cystectomy. / Trentman, Terrence L.; Fassett, Sharon L.; McGirr, Dustin; Anderson, Brad; Chang, Yu Hui H; Nateras, Rafael Nunez; Castle, Erik P; Rosenfeld, David M.

In: Journal of Robotic Surgery, Vol. 7, No. 3, 09.2013, p. 273-279.

Research output: Contribution to journalArticle

Trentman, TL, Fassett, SL, McGirr, D, Anderson, B, Chang, YHH, Nateras, RN, Castle, EP & Rosenfeld, DM 2013, 'Comparison of anesthetic management and outcomes of robot-assisted versus open radical cystectomy', Journal of Robotic Surgery, vol. 7, no. 3, pp. 273-279. https://doi.org/10.1007/s11701-012-0379-7
Trentman, Terrence L. ; Fassett, Sharon L. ; McGirr, Dustin ; Anderson, Brad ; Chang, Yu Hui H ; Nateras, Rafael Nunez ; Castle, Erik P ; Rosenfeld, David M. / Comparison of anesthetic management and outcomes of robot-assisted versus open radical cystectomy. In: Journal of Robotic Surgery. 2013 ; Vol. 7, No. 3. pp. 273-279.
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