The effect of surgical technique on hemodynamics, arterial oxygenation and pulmonary mechanics in radical prostatectomy operations

Objective: The effects of surgical technique on respiratory mechanics, arterial oxygenation and hemodynamics in radical prostatectomy operation were investigated. Methods: The study was planned on ASA II-III, 40-65 years old, fourty patients scheduled for radical prostatectomy under general anesthesia. They were divided into two groups: perineal and suprapubic (Group P, n = 20; Group S, n = 20). Heart rate, mean arterial blood pressure, arterial oxygen saturation (SpO₂), partial pressure of end-tidal carbon dioxide (PEtCO₂), Peak inspiratory pressure (PIP), plato pressure (Pplato), partial pressure of oxygen in arterial blood (PaO2), partial pressure of carbon dioxide in arterial blood (PaCO₂) values were evaluated at 10 minutes after induction. After the position applied for surgery in the 30.60 and 90^th minutes, the Alveolar-arterial oxygen pressure gradient (P(A-a) O₂), the ratio of physiologic dead space over tidal volume (VD/VT), arterial to end tidal CO2 gradient (P(a-et) CO₂), static compliance (CS), dynamic compliance (CD) were assessed. Results: In the assessment of groups, there were not statistical differences about mean blood pressure, heart rate, SpO₂, PetCO₂, PaO₂, plateau pressure, and P (A-a) values (p > 0.05). Peak inspiratory pressure was higher in Group P. Peak inspiratory pressure and plateau pressure increased with CO₂ insufflation in Group P. PaCO₂ and P(a-et) CO₂ were higher statistically significantly in Group 0. There was no difference in terms of the PetCO₂ values. VD/VT ratios were statistically significantly lower in the Group P. Conclusions: Suprapubic surgery was shown to improve oxygenation and respiratory mechanics without causing any hemodynamic side effect in radical prostatectomy operation.