{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T21:54:08Z","timestamp":1785362048139,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T00:00:00Z","timestamp":1672876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The clinical impact of prolonged steep Trendelenburg position and CO<jats:sub>2<\/jats:sub> pneumoperitoneum during robot\u2010assisted radical cystectomy (RC) on intraoperative conditions and immediate postoperative recovery remains to be assessed. The current study investigates intraoperative and immediate postoperative outcomes for open RC (ORC) versus robot\u2010assisted RC with intracorporal urinary diversion (iRARC) in a blinded randomised trial. We hypothesised that ORC would result in a faster haemodynamic and respiratory post\u2010anaesthesia care unit (PACU) recovery compared to iRARC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study is a predefined sub\u2010analysis of a single\u2010centre, double\u2010blinded, randomised feasibility study. Fifty bladder cancer patients were randomly assigned to ORC (n\u00a0=\u00a025) or iRARC (<jats:italic>n<\/jats:italic>\u00a0=\u00a025). Patients, PACU staff, and ward personnel were blinded to the surgical technique. Both randomisation arms followed the same anaesthesiologic procedure, fluid treatment plan, and PACU care. The primary outcome was immediate postoperative recovery using a standardised PACU Discharge Criteria (PACU\u2010DC) score. Secondary outcomes included respiration\u2010 and arterial O<jats:sub>2<\/jats:sub> saturation scores as well as perioperative interventions and recordings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All patients underwent the allocated treatment. The total PACU\u2010DC score was highest 6\u2009h postoperatively with no difference in the total score between randomisation arms (p\u00a0=\u00a00.80). Both the ORC and iRARC groups maintained a mean respiration\u2010 and arterial O<jats:sub>2<\/jats:sub> saturation score below 1 (out of 3) throughout PACU stay. The iRARC patients had significantly, but clinically acceptable, higher maximum airway pressure and arterial blood pressure, as well as lower minimum pH levels. The ORC group received significantly more opioids after extubation but marginally less analgesics in the PACU, compared to the iRARC group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A prolonged Trendelenburg position and CO<jats:sub>2<\/jats:sub> pneumoperitoneum was well\u2010tolerated during iRARC, and immediate postoperative recovery was similar for ORC and iRARC patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14187","type":"journal-article","created":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T06:15:06Z","timestamp":1671776106000},"page":"293-301","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Haemodynamic and respiratory perioperative outcomes for open versus robot\u2010assisted radical cystectomy: A double\u2010blinded, randomised trial"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6907-2609","authenticated-orcid":false,"given":"Maja","family":"Vejlgaard","sequence":"first","affiliation":[{"name":"Urological Research Unit, Department of Urology, Centre for Cancer and Organ Diseases Copenhagen University Hospital\u2013Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5489-2521","authenticated-orcid":false,"given":"Sophia L.","family":"Maibom","sequence":"additional","affiliation":[{"name":"Urological Research Unit, Department of Urology, Centre for Cancer and Organ Diseases Copenhagen University Hospital\u2013Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5400-4531","authenticated-orcid":false,"given":"Ulla N.","family":"Joensen","sequence":"additional","affiliation":[{"name":"Urological Research Unit, Department of Urology, Centre for Cancer and Organ Diseases Copenhagen University Hospital\u2013Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2209-1711","authenticated-orcid":false,"given":"Henrik","family":"Kehlet","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"},{"name":"Section for Surgical Pathophysiology, The Juliane Marie Centre Copenhagen University Hospital\u2013Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Bundgaard\u2010Nielsen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Centre for Cancer and Organ Diseases Copenhagen University Hospital\u2013Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7131-2461","authenticated-orcid":false,"given":"Eske K.","family":"Aasvang","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Anaesthesiology, Centre for Cancer and Organ Diseases Copenhagen University Hospital\u2013Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0019-5333","authenticated-orcid":false,"given":"Andreas","family":"R\u00f8der","sequence":"additional","affiliation":[{"name":"Urological Research Unit, Department of Urology, Centre for Cancer and Organ Diseases Copenhagen University Hospital\u2013Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen 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