title: Effects of steep Trendelenburg position and pneumoperitoneum on middleear pressure in patients undergoing robotic radical prostatectomy.
abstract: The aim of this study was to quantify the changes in middle ear pressure (MEP) during robot-assisted radical prostatectomy (RARP).
  
  
  
  Thirty patients undergoing RARP were included in this study. MEP was obtained at the following time points: awake (T1), postintubation (T2), pneumoperitoneum + 1 h of Trendelenburg position (T3), pneumoperitoneum + 2 h of Trendelenburg position (T4), pneumoperitoneum + 3 h of Trendelenburg position (T5), desufflation + supine position (T6), and 1 h after extubation in the postanesthesia care unit (T7). Heart rate, mean arterial pressure (MAP), peak airway pressure (PAP), tidal volume, minute ventilation, EtCO2, and blood gas values were recorded.
  
  
  
  MEP was significantly higher at T4, T5, T6, and T7 as compared to T1 values. PAP values were significantly increased at T3, T4, and T5 compared to T2. MAP values at T3, T4, and T5 were significantly higher compared to T1. PaCO2increased significantly at T4, T5, and T6 and pH decreased significantly at T4 and T5 when compared to T2.
  
  
  
  The combination of steep Trendelenburg position and pneumoperitoneum during RARP caused a significant increase in MEP, PaCO2, and EtCO2levels. This propensity for increased MEP may cause problems in patients with preexisting ear disease.
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Fusun
authors.initials: F
authors.lastname: Bozkirli
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Nurdan
authors.initials: N
authors.lastname: Bedirli
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Akçabay
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002245:Carbon Dioxide / Q000097:blood; D004432:Ear, Middle / Q000502:physiology*; D018475:Head-Down Tilt / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D010313:Partial Pressure; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects*; D065287:Robotic Surgical Procedures / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D002245:Carbon Dioxide