Several ischemic optic neuropathies that occurred during robotic-assisted laparoscopic radical prostatectomy (RALRP) have been reported to be due to the Trendelenburg position, which lowers ocular perfusion pressure (OPP). We examined changes in pulsatile ocular blood flow (POBF) and its correlation with OPP during RALRP in the steep Trendelenburg position.
Pulsatile ocular blood flow and intraocular pressure (IOP) were measured in 50 patients by the OBF Langham System 5 times during RALRP. The mean arterial blood pressure (MAP), heart rate, plateau airway pressure, and end-tidal CO2 (EtCO2) at each time point were recorded. Ocular perfusion pressure was calculated from simultaneous IOP and MAP measurements.
Pulsatile ocular blood flow was 15.53 ± 3.32 µL/s at T0, 18.99 ± 4.95 µL/s at T1, 10.04 ± 3.24 µL/s at T2, 11.45 ± 3.02 µL/s at T3, and 15.07 ± 3.81 µL/s at T4. Ocular perfusion pressure was 70.15 ± 5.98 mm Hg at T0, 64.21 ± 6.77 mm Hg at T1, 57.71 ± 7.07 mm Hg at T2, 51.73 ± 11.58 mm Hg at T3, and 64.21 ± 12.37 mm Hg at T4. Repeated-measures analysis of variance on POBF and OPP was significant (p>0.05). This difference disappeared when the correlation between MAP and POBF, EtCO2 and POBF, and EtCO2 and OPP were considered, while correlation between MAP and OPP confirmed the difference. The regression analysis between POBF and OPP showed a statistically significant difference at T0 and T3 (r = 0.047, p = 0.031 and r = 0.096, p = 0.002, respectively).
Pulsatile ocular blood flow and OPP reached the lowest level at the end of surgery.
Post author correction
Article Type: ORIGINAL RESEARCH ARTICLE
Article Subject: Neuro Ophthalmology
AuthorsChristian L. Demasi, Francesco Porpiglia, Augusto Tempia, Savino D’Amelio
- • Accepted on 04/10/2017
- • Available online on 25/10/2017
This article is available as full text PDF.
- Demasi, Christian L. [PubMed] [Google Scholar] 1
- Porpiglia, Francesco [PubMed] [Google Scholar] 2
- Tempia, Augusto [PubMed] [Google Scholar] 3
- D’Amelio, Savino [PubMed] [Google Scholar] 1, * Corresponding Author (firstname.lastname@example.org)
Department of Paediatric Ophthalmology, Ophthalmic Hospital C. Sperino, Turin - Italy
Department of Urology, University of Turin, San Luigi Gonzaga Hospital, Orbassano (Turin) - Italy
Anaesthesia and Reanimation Department, University of Turin, San Luigi Gonzaga Hospital, Orbassano (Turin) - Italy