Anesthesia Management in Robotic-Assisted Surgery: Evaluating Challenges, Benefits, And Patient Outcomes in Geriatric Populations

Abstract

Background: Robotic-assisted surgery (RAS) has revolutionized surgical practices, particularly in the geriatric population, by offering advantages such as reduced complication rates, less blood loss, and shorter hospital stays compared to conventional approaches. However, the unique challenges posed by RAS, particularly concerning anesthesia management, necessitate careful consideration of patient safety and outcomes.

Methods: This review analyzes the physiological implications of RAS, focusing on the hemodynamic, pulmonary, and neurological challenges associated with pneumoperitoneum and extreme positioning during surgery. A comprehensive literature review was conducted to evaluate the impact of these factors on patient outcomes, with a specific emphasis on the elderly demographic.

Results: Findings indicate that pneumoperitoneum can significantly alter hemodynamic stability, leading to increased systemic vascular resistance and reduced cardiac output, particularly in patients with pre-existing cardiovascular conditions. Additionally, extreme positions, such as steep Trendelenburg, exacerbate these effects, potentially resulting in cerebral and myocardial hypoperfusion. The review also highlights the importance of tailored anesthesia strategies, including fluid management and neuromuscular blockade, to mitigate these risks.

Conclusion: While RAS offers distinct advantages, the associated anesthesia challenges require meticulous planning and coordination between surgical and anesthetic teams. Implementing strategies to minimize pneumoperitoneum pressure and limiting the duration of extreme positioning can enhance patient safety and optimize postoperative outcomes. Continued research is essential to refine protocols and ensure safe practice in vulnerable patient populations.