The Effect of Arterial Carbon Dioxide Levels on Cerebral Blood Flow and Cerebral Autoregulation in the Steep Trendelenburg Position During Robot-assisted Prostatectomy, and Its Effect on Postoperative Cognition

Launched by UNIVERSITY HOSPITAL, AKERSHUS · Mar 5, 2025

Keywords

ClinConnect Summary

Detailed Description: The carotid artery carries blood into the brain. Therefore, blood flow levels in the carotid artery may be used to assess brain perfusion. Brain perfusion is carefully regulated by the body, to ensure that the brain always receives enough oxygen and nutrients. During prostate surgery using laparoscopic techniques, the patient lies tilted on the operating table, with their head markedly lower than their legs. The investigators aim to study the effect on cerebral blood flow of a head-down tilted body position in combination with anesthesia and laparoscopic surgery, and p...

Gender

MALE

Eligibility criteria

• • Inclusion Criteria: Males 55-80 years old, accepted by surgeon and attending anesthesiologist for RALP surgery.
• Exclusion Criteria:
• • Poorly controlled hypertension (resting BP \>165/90 on pre-study consult).
• • Emphysema of the lung.
• • Previous spontaneous pneumothorax.
• • Cerebrovascular disease. Including but not limited to previous SAH, EDH, SDH, hemorrhage from AVM, known AVM and stenosis in carotid or cerebral arteries.
• • Intracranial malignancy or metastases from primary cancer.
• • Significant cardiovascular disease (NYHA class III or IV).
• • Renal failure grade 4 or 5 (estimated GFR \<30).
• • Anatomical hinders for performing ultrasound of the right carotid artery or middle cerebral artery.
• • Primary language other than Scandinavian.
• • Diagnosed dementia of any subtype.