TY - JOUR
T1 - Joint consensus on anesthesia in urologic and gynecologic robotic surgery: Specific issues in management from a task force of the SIAARTI, SIGO, and SIU
AU - Aceto, Paola
AU - Beretta, Luigi
AU - Cariello, Claudia
AU - Claroni, Claudia
AU - Esposito, Clelia
AU - Forastiere, Ester M.
AU - Guarracino, Fabio
AU - Perucca, Raffaella
AU - Romagnoli, Stefano
AU - Sollazzi, Liliana
AU - Cela, Vito
AU - Ercoli, Alfredo
AU - Scambia, Giovanni
AU - Vizza, Enrico
AU - Ludovico, Giuseppe M.
AU - Sacco, Emilio
AU - Vespasiani, Giuseppe
AU - Scudeller, Luigia
AU - Corcione, Antonio
PY - 2019
Y1 - 2019
N2 - INTRODUCTION: Proper management of patients undergoing robotic-assisted urologic and gynecologic surgery must consider a series of peculiarities in the procedures for anesthesiology, critical care medicine, respiratory care, and pain management. Although the indications for robotic-assisted urogynecologic surgeries have increased in recent years, specific guidance documents are still lacking. EVIDENCE ACQUISITION: A multidisciplinary group including anesthesiologists, gynecologists, urologists, and a clinical epidemiologist systematically reviewed the relevant literature and provided a set of recommendations and unmet needs on peculiar aspects of anesthesia in this field. EVIDENCE SYNTHESIS: Nine core contents were identified, according to their requirements in urogynecologic robotic-assisted surgery: patient position, pneumoperitoneum and ventilation strategies, hemodynamic variations and fluid therapy, neuromuscular block, renal surgery and prevention of acute kidney injury, monitoring the Department of anesthesia, postoperative delirium and cognitive dysfunction, prevention of postoperative nausea and vomiting, and pain management in endometriosis. CONCLUSIONS: This consensus document provides guidance for the management of urologic and gynecologic patients scheduled for robotic-assisted surgery. Moreover, the identified unmet needs highlight the requirement for further prospective randomized studies.
AB - INTRODUCTION: Proper management of patients undergoing robotic-assisted urologic and gynecologic surgery must consider a series of peculiarities in the procedures for anesthesiology, critical care medicine, respiratory care, and pain management. Although the indications for robotic-assisted urogynecologic surgeries have increased in recent years, specific guidance documents are still lacking. EVIDENCE ACQUISITION: A multidisciplinary group including anesthesiologists, gynecologists, urologists, and a clinical epidemiologist systematically reviewed the relevant literature and provided a set of recommendations and unmet needs on peculiar aspects of anesthesia in this field. EVIDENCE SYNTHESIS: Nine core contents were identified, according to their requirements in urogynecologic robotic-assisted surgery: patient position, pneumoperitoneum and ventilation strategies, hemodynamic variations and fluid therapy, neuromuscular block, renal surgery and prevention of acute kidney injury, monitoring the Department of anesthesia, postoperative delirium and cognitive dysfunction, prevention of postoperative nausea and vomiting, and pain management in endometriosis. CONCLUSIONS: This consensus document provides guidance for the management of urologic and gynecologic patients scheduled for robotic-assisted surgery. Moreover, the identified unmet needs highlight the requirement for further prospective randomized studies.
KW - Anesthesia
KW - Gynecology
KW - Pneumoperitoneum
KW - Robotic surgical procedures
KW - Urology
KW - Anesthesia
KW - Gynecology
KW - Pneumoperitoneum
KW - Robotic surgical procedures
KW - Urology
UR - http://hdl.handle.net/10807/150023
U2 - 10.23736/S0375-9393.19.13360-3
DO - 10.23736/S0375-9393.19.13360-3
M3 - Article
SN - 0375-9393
VL - 85
SP - 871
EP - 885
JO - Minerva Anestesiologica
JF - Minerva Anestesiologica
ER -