Anaesthetic considerations for robotic surgery

Key points:

Maintain muscle paralysis while robot is docked – consider infusion of relaxant

Meticulous positioning with pressure point protection

Difficult to access patient intra-op

Have enough slack on lines

If steep trendelunburg e.g. prostatectomy caution with fluids, raised ICP and IOP, airway oedema.

Recipe for radical prostatectomy:

GA, ETT, 2x IVI, a-line

O2/air/desflurane. MAC 0.8-1.0

Remifentanil (0.1-0.2mcg/kg/min) and atracurium infusion

<500ml prior to anastomosis, max 2000ml in total (if no significant blood loss).

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