Sakai Yoko, Yasuo M Tsutsumi, Oyama Takuro, Murakami Chiaki, Kakuta Nami, Tanaka Katsuya
Department of Anesthesiology, Institute of Biomedical Sciences, Tokushima University Graduate School.
J Med Invest. 2018;65(1.2):69-73. doi: 10.2152/jmi.65.69.
Robot-assisted laparoscopic radical prostatectomy (RALRP) is commonly performed in the surgical treatment of prostate cancer. However, the steep Trendelenburg position (25) and pneumoperitoneum required for this procedure can sometimes cause hemodynamic changes. Although blood pressure is traditionally monitored invasively during RALRP, the ClearSight system (BMEYE, Amsterdam, The Netherlands) enables a totally noninvasive and simple continuous blood pressure and cardiac output monitoring based on finger arterial pressure pulse contour analysis. We therefore investigated whether noninvasive continuous arterial blood pressure measurements using the ClearSight system were comparable to those obtained invasively in patients undergoing RALRP. Ten patients scheduled for RALRP with American Society of Anesthesiologists physical status I-II were included in this study. At each of the seven defined time points, noninvasive and invasive blood pressure measurements were documented and compared in each patient using Bland-Altman analysis. Although the blood pressure measured with the ClearSight system correlated with that measured invasively, a large difference between the values obtained by the two devices was noted. The ClearSight system was unable to detect blood pressure accurately during RALRP, suggesting that blood pressure monitoring using this device alone is not feasible in this small patient population. J. Med. Invest. 65:69-73, February, 2018.
机器人辅助腹腔镜前列腺癌根治术（RALRP）常用于前列腺癌的外科治疗。然而，该手术所需的陡峭头低脚高位（25°）和气腹有时会引起血流动力学变化。虽然传统上在RALRP期间通过有创方式监测血压，但ClearSight系统（荷兰阿姆斯特丹的BMEYE公司）能够基于手指动脉压力脉搏轮廓分析实现完全无创且简单的连续血压和心输出量监测。因此，我们研究了使用ClearSight系统进行的无创连续动脉血压测量与接受RALRP患者的有创测量结果是否具有可比性。本研究纳入了10例计划接受RALRP且美国麻醉医师协会身体状况分级为I-II级的患者。在七个定义的时间点中的每一个时间点，记录每位患者的无创和有创血压测量值，并使用Bland-Altman分析进行比较。尽管使用ClearSight系统测量的血压与有创测量结果相关，但注意到两种设备获得的值之间存在很大差异。ClearSight系统在RALRP期间无法准确检测血压，这表明在这个小患者群体中仅使用该设备进行血压监测是不可行的。《医学调查杂志》65:69 - 73，2018年2月。
