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Objectives Robotic-assisted laparoscopic prostatectomy (RALP) is typically conducted in steep Trendelenburg position (STP). This study investigated the influence of permanent 45° STP and capnoperitoneum on haemodynamic parameters during and after RALP.Design Prospective observational study.Setting Haemodynamic changes were recorded with transpulmonary thermodilution and pulse contour analysis in men undergoing RALP under standardised anaesthesia.Participants Informed consent was obtained from 51 patients scheduled for elective RALP in a University Medical Centre in Germany.Interventions Heart rate, mean arterial pressure, central venous pressure (CVP), Cardiac Index (CI), systemic vascular resistance (SVR), Global End-Diastolic Volume Index (GEDI), global ejection fraction (GEF), Cardiac Power Index (CPI) and stroke volume variation (SVV) were recorded at six time points: 20 min after induction of anaesthesia (T1), after insufflation of capnoperitoneum in supine position (T2), after 30 min in STP (T3), when controlling Santorini’s plexus in STP (T4), before awakening in supine position (T5) and after 45 min in the recovery room (T6). Adverse cardiac events were registered intraoperatively and postoperatively.Results All haemodynamic parameters were significantly changed by capnoperitoneum and STP during RALP and partly normalised at T6. CI, GEF and CPI were highest at T6 (CI: 3.9 vs 2.2 L/min/m²; GEF: 26 vs 22%; CPI: 0.80 vs 0.39 W/m²; p

Abstract Background  The purpose of the study was to investigate the evolution of central corneal thickness (CCT) in correlation to the intraocular pressure (IOP) in children with congenital glaucoma before and after glaucoma surgery. Methods  Nine eyes of five children (age 2 weeks to 6 months, mean 23 weeks) underwent trabeculotomy for congenital glaucoma. Corneal ultrasound pachymetry (PacScan 3000 AP, Technomed, Germany), tonometry using the Perkins tonometer, and slit-lamp examination (additionally to a clinical routine examination with retinoscopy, funduscopy, measurement of axial length and corneal diameter) were performed before and for at least 12 months after glaucoma surgery. In all children, corneal pachymetry and slit-lamp biomicroscopy—and whenever possible applanation tonometry—were performed without sedation or general anesthesia. If measurement of the IOP was not possible otherwise (in four of the five children), sedation with midazolam orally was used to measure the IOP at 2 weeks, 6 weeks, and 3 months after trabeculotomy, then every 3 months. Results  Six of nine eyes had biomicroscopically clear corneas without visible corneal edema before trabeculotomy. In three eyes, a corneal edema was visible in at least one quadrant of the cornea. Regarding all eyes together, mean CCT was 651 ± 138 μm before trabeculotomy; this decreased to 592 ± 119 μm within 2 weeks after trabeculotomy. At 6 weeks and 3 months there was a further regression to 569.4 ± 16 μm. Mean IOP was 18.6 ± 7.5 mmHg before and decreased to 14.8 ± 5.8 mmHg after glaucoma surgery. Regarding IOP data obtained under general anaesthesia, decrease of CCT was significantly correlated with decrease in IOP. There was no significant difference in the correlation between eyes with and without visible corneal edema. Conclusions  Corneal ultrasound pachymetry appears to be a valuable additional measure in the follow-up of infants and small children requiring glaucoma surgery. [ABSTRACT FROM AUTHOR]