Journal of Clinical Trials
Open Access
ISSN: 2167-0870
ISSN: 2167-0870
Department of Neurology, Canisius Wilhelmina Hospital, Nijmegen, Netherlands
Research Article
Low Pressure Pneumoperitoneum and Deep Neuromuscular Block Versus Standard Laparoscopy during Robot Assisted Radical Prostatectomy to Improve the Quality of Recovery and Immune Homeostasis: Study Protocol for a Randomized Controlled Study
Author(s): G.T.J.A. Reijnders-Boerboom*, J.P. van Basten, L.M.C. Jacobs, M. Brouwer, M. van Dijck, K.I Albers, I.F. Panhuizen, G.J. Scheffer, C. Keijzer and M.C. Warlé
Background: A pneumoperitoneum with Carbon Dioxide (CO2) is required to obtain an adequate surgical field for laparoscopic surgery, including Robot Assisted Radical Prostatectomy (RARP). Nevertheless, the use of an increased Intra-Abdominal Pressure (IAP) may have a negative impact on the quality of recovery after surgery. IAP causes a temporary decrease in the perfusion of surrounding tissues leading to ischemia-reperfusion injury with oxidative stress and release of Danger Associated Molecular Patterns (DAMPs). Thereby contributing to pain and inflammation which has a negative impact on the quality of recovery. With accumulating evidence demonstrating the safety and advantages of low-pressure IAP (6-8 mmHg), such as reduction in postoperative pain, opioid consumption, improved bowel function recovery, a reduced inflammatory response and preserving innate .. View More»