Correlation Between Oxygen Reserve Index Monitoring and Blood Gas Oxygen Values During Anesthesia in Robotic Total Prostatectomy Surgery

Overview

Journal BMC Anesthesiol

Publisher Biomed Central

Date 2025 Jan 28

PMID 39871146

Authors

Hilal Zengin

Affiliations

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Abstract

Introduction-objective: Hyperoxia is associated with acute lung injury and atelectasis. Arterial blood gas measurement is an invasive method. The Oxygen Reserve Index (ORI) was developed to monitor the oxygen values of patients. In this study, we aimed to find out whether safe monitoring against hyperoxia could be achieved in Robotic-Assisted Radical Prostatectomy (RARP) operations by using ORI, which is an easier measurement method compared to arterial blood gas measurements.

Materials And Methods: The study was carried out with adult male patients over the age of 18 who underwent RARP with the diagnosis of prostate cancer. An ORI pulse oximeter was additionally attached to their index fingers for ORI monitoring. The moment when ORI values were first read was considered the baseline, and arterial blood gas and ORI values were recorded simultaneously at the baseline (T1), 30 min later (T2), 1 h later (T3), 3 h later (T4), and 5 h later (T5). The correlations between the simultaneously recorded ORI and arterial blood gas values were analyzed.

Results: The sample of the study included 24 male patients. The mean age of the patients was 63.30 ± 7.74, their mean BMI (kg/m) was 26.64 ± 2.84, and their mean duration of operation was 351.52 ± 48.72 min. The mean ORI value in all measurements was 0.36 (median: 0.28, SD: 0.3694). In the ROC curve analysis conducted to determine the optimal cut-off point for ORI to detect PaO ≥ 150 mmHg, the AUC was 0.901 (95% CI: 0.821-0.981), and the cut-off value obtained based on the ROC curve (cut point ORI) was 0.220 (sensitivity: 0.826, specificity: 0.771). The results of the linear regression analysis showed a strong relationship between ORI and PaO (PaO < 240 mmHg) [simple linear regression, n = 90; r = 0.505, p < 0.001].

Conclusion: The results of this study demonstrated a significant connection between ORI and PO values in their simultaneous interpretation at PO values lower than 240. Because the sensitivity of ORI to PO is low in cases of severe hyperoxia, blood gas analyses will be needed.

References

Applegate 2nd R, Dorotta I, Wells B, Juma D, Applegate P . The Relationship Between Oxygen Reserve Index and Arterial Partial Pressure of Oxygen During Surgery. Anesth Analg. 2016; 123(3):626-33. PMC: 4979626. DOI: 10.1213/ANE.0000000000001262. View

Scheeren T, Belda F, Perel A . The oxygen reserve index (ORI): a new tool to monitor oxygen therapy. J Clin Monit Comput. 2017; 32(3):379-389. PMC: 5943373. DOI: 10.1007/s10877-017-0049-4. View

Pandey R, Garg R, Roy K, Darlong V, Punj J, Kumar A . Perianesthetic management of the first robotic partial cystectomy in bladder pheochromocytoma. A case report. Minerva Anestesiol. 2010; 76(4):294-7. View

Fan Q, Chen M, Fang X, Lau W, Xue L, Zhao L . Aging might augment reactive oxygen species (ROS) formation and affect reactive nitrogen species (RNS) level after myocardial ischemia/reperfusion in both humans and rats. Age (Dordr). 2012; 35(4):1017-26. PMC: 3705100. DOI: 10.1007/s11357-012-9421-y. View

Nahas W, Rodrigues G, Rodrigues Goncalves F, Sawczyn G, Barros G, Cardili L . Perioperative, Oncological, and Functional Outcomes Between Robot-Assisted Laparoscopic Prostatectomy and Open Radical Retropubic Prostatectomy: A Randomized Clinical Trial. J Urol. 2024; 212(1):32-40. DOI: 10.1097/JU.0000000000003967. View

Yoshida K, Isosu T, Noji Y, Hasegawa M, Iseki Y, Oishi R . Usefulness of oxygen reserve index (ORi™), a new parameter of oxygenation reserve potential, for rapid sequence induction of general anesthesia. J Clin Monit Comput. 2017; 32(4):687-691. DOI: 10.1007/s10877-017-0068-1. View

Esperto F, Cacciatore L, Tedesco F, Testa A, Calle P, Ragusa A . Impact of Robotic Technologies on Prostate Cancer Patients' Choice for Radical Treatment. J Pers Med. 2023; 13(5). PMC: 10220733. DOI: 10.3390/jpm13050794. View

Tsymbal E, Ayala S, Singh A, Applegate 2nd R, Fleming N . Study of early warning for desaturation provided by Oxygen Reserve Index in obese patients. J Clin Monit Comput. 2020; 35(4):749-756. PMC: 8286939. DOI: 10.1007/s10877-020-00531-w. View

Koishi W, Kumagai M, Ogawa S, Hongo S, Suzuki K . Monitoring the Oxygen Reserve Index can contribute to the early detection of deterioration in blood oxygenation during one-lung ventilation. Minerva Anestesiol. 2018; 84(9):1063-1069. DOI: 10.23736/S0375-9393.18.12622-8. View

10.

Fan Q, Chen L, Cheng S, Li F, Lau W, Wang L . Aging aggravates nitrate-mediated ROS/RNS changes. Oxid Med Cell Longev. 2014; 2014:376515. PMC: 3981534. DOI: 10.1155/2014/376515. View

11.

Coughlin G, Yaxley J, Chambers S, Occhipinti S, Samaratunga H, Zajdlewicz L . Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: 24-month outcomes from a randomised controlled study. Lancet Oncol. 2018; 19(8):1051-1060. DOI: 10.1016/S1470-2045(18)30357-7. View

12.

Campos J, Sharma A . Predictors of Hypoxemia During One-Lung Ventilation in Thoracic Surgery: Is Oxygen Reserve Index (ORi) the Answer?. J Cardiothorac Vasc Anesth. 2019; 34(2):423-425. DOI: 10.1053/j.jvca.2019.08.017. View

13.

Meyhoff C, Staehr A, Rasmussen L . Rational use of oxygen in medical disease and anesthesia. Curr Opin Anaesthesiol. 2012; 25(3):363-70. DOI: 10.1097/ACO.0b013e328352b402. View

14.

Gandi C, Marino F, Totaro A, Scarciglia E, Presutti S, Bellavia F . Hugo™ Versus daVinci™ Robot-Assisted Radical Prostatectomy: 1-Year Propensity Score-Matched Comparison of Functional and Oncological Outcomes. J Clin Med. 2024; 13(22). PMC: 11594860. DOI: 10.3390/jcm13226910. View

15.

Gainsburg D . Anesthetic concerns for robotic-assisted laparoscopic radical prostatectomy. Minerva Anestesiol. 2012; 78(5):596-604. View

16.

Kallet R, Matthay M . Hyperoxic acute lung injury. Respir Care. 2012; 58(1):123-41. PMC: 3915523. DOI: 10.4187/respcare.01963. View

17.

Ragusa A, Brassetti A, Prata F, Iannuzzi A, Calle P, Tedesco F . Predictors of Urinary Continence Recovery after Laparoscopic-Assisted Radical Prostatectomy: Is Surgical Urethral Length the Only Key Factor?. Life (Basel). 2023; 13(7). PMC: 10381846. DOI: 10.3390/life13071550. View

18.

Civitella A, Prata F, Papalia R, Citriniti V, Tuzzolo P, Pascarella G . Laparoscopic versus Ultrasound-Guided Transversus Abdominis Plane Block for Postoperative Analgesia Management after Radical Prostatectomy: Results from a Single Center Study. J Pers Med. 2023; 13(12). PMC: 10744694. DOI: 10.3390/jpm13121634. View

19.

Suzuki S, Eastwood G, Peck L, Glassford N, Bellomo R . Current oxygen management in mechanically ventilated patients: a prospective observational cohort study. J Crit Care. 2013; 28(5):647-54. DOI: 10.1016/j.jcrc.2013.03.010. View

20.

Mian A, Tollefson M, Shah P, Sharma V, Mian A, Thompson R . Navigating Now and Next: Recent Advances and Future Horizons in Robotic Radical Prostatectomy. J Clin Med. 2024; 13(2). PMC: 10815957. DOI: 10.3390/jcm13020359. View