RELATIONSHIP OF MRI-MEASURED PELVIMETRIC DIMENSIONS AND SURGICAL POSITIONS WITH ANAESTHESIA PARAMETERS IN ROBOTIC PERINEAL PROSTATECTOMY

INTRODUCTION AND OBJECTIVE: The aim of this study was to determine the effect formed by pelvic diameters preoperatively measured through multiparametric magnetic resonance imaging (mp-MRI) and different surgical positions on anesthesia parameters used during perineal robot-assisted radical prostatectomy (p-RARP). MATERIALS AND METHODS: Six different pelvimetric dimensions were determined preoperatively. Respiratory and hemodynamic variables of the patients were measured separately and repeatedly in the supine position, exaggerated lithotomy position at the beginning of the 15° Trendelenburg position and the 60th minute of insufflation. RESULTS: There was a significant increase in the partial pressure of oxygen (PaO₂) in the exaggerated lithotomy position compared to the supine position. There was no significant change in the partial pressure of carbon dioxide (PCO₂) in the exaggerated lithotomy position compared to the supine position. In the 60th minute of insufflation, there was a significant increase in the PCO₂ compared to the supine and exaggerated lithotomy positions. There was no statistically significant change in the end-tidal carbon dioxide tension (EtCO₂), with surgical position or insufflation time. A significant negative correlation was observed between the distance of the ischial spines (ISD) and PCO₂ change, and a significant positive correlation was observed between the angle of the symphysis pubis-seminal vesicles (ASS) and PCO₂ change. A significant positive correlation was observed between the ASS value and EtCO₂ change between the 60th minute of insufflation and exaggerated lithotomy position. CONCLUSION: In our study, the effect caused by differing pelvimetric diameters, surgical positions, and duration of anesthesia during p-RARP on anesthesia parameters were shown.