Evidence map›Paper›PMID 39917591›Full record

ReviewEuropean journal of anaesthesiology and intensive care2023

Challenges for anaesthesia for robotic-assisted surgery in the elderly: A narrative review.

Paola Aceto, Claudia Galletta, Chiara Cambise, Giovanni Punzo, Ersilia Luca, Chiara Schipa, Liliana Sollazzi

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in European journal of anaesthesiology and intensive care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Robotic versus Laparoscopic Hiatal Hernia Repair in Elderly Patients.JSLS : Journal of the Society of Laparoendoscopic Surgeons
    Pooled it
  2. Trial
  3. Review
  4. Article
  5. Article
  6. Observational
  7. Review
  8. Review
  9. Perioperative analgesia in the elderly.Saudi journal of anaesthesia
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Paola AcetoFrom the Dipartimento di Scienze dell' Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (AP, CG, CC, GP, EL, CS, LS), Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie, Università, Cattolica del Sacro Cuore, Rome, Italy (AP, LS).
Claudia GallettaFrom the Dipartimento di Scienze dell' Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (AP, CG, CC, GP, EL, CS, LS), Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie, Università, Cattolica del Sacro Cuore, Rome, Italy (AP, LS).
Chiara CambiseFrom the Dipartimento di Scienze dell' Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (AP, CG, CC, GP, EL, CS, LS), Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie, Università, Cattolica del Sacro Cuore, Rome, Italy (AP, LS).
Giovanni PunzoFrom the Dipartimento di Scienze dell' Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (AP, CG, CC, GP, EL, CS, LS), Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie, Università, Cattolica del Sacro Cuore, Rome, Italy (AP, LS).
Ersilia LucaFrom the Dipartimento di Scienze dell' Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (AP, CG, CC, GP, EL, CS, LS), Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie, Università, Cattolica del Sacro Cuore, Rome, Italy (AP, LS).
Chiara SchipaFrom the Dipartimento di Scienze dell' Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (AP, CG, CC, GP, EL, CS, LS), Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie, Università, Cattolica del Sacro Cuore, Rome, Italy (AP, LS).
Liliana SollazziFrom the Dipartimento di Scienze dell' Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (AP, CG, CC, GP, EL, CS, LS), Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie, Università, Cattolica del Sacro Cuore, Rome, Italy (AP, LS).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Steep and reverse Trendelenburg positions are often used in robotic-assisted surgery (RAS) to improve surgical access. The elderly are particularly vulnerable to the cardiovascular effect of the combination of pneumoperitoneum and these extreme positions. Falls in both cardiac output (CO) and mean arterial pressure (MAP) caused by pneumoperitoneum are enhanced in reverse Trendelenburg. Hypotension with dangerous cerebral and myocardial hypoperfusion may occur. Caution should be exercised in patients with low cardiac reserve and the degree of peri-operative risk should dictate the level of haemodynamic monitoring employed. The effects of pneumoperitoneum on CO are less pronounced in the standard Trendelenburg position due to gravity, but head-down combined with pneumoperitoneum can increase both MAP and systemic cardiovascular resistance. However, in patients with impaired myocardial contractility, the head-down position may lead to cardiac failure. In addition, the adverse respiratory effects of pneumoperitoneum, which include reduction of pulmonary compliance and functional residual capacity, may be exacerbated by steep Trendelenburg. At the same time, hypercarbia resulting from CO

Identifiers

PMID39917591
PMCPMC11783671

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.