Robotic Mitral Valve Repair: A Review of Anesthetic Management of the First 200 Patients

摘要: Objective The aim of this study was to describe the evolution in anesthetic technique used for first 200 patients undergoing robotic mitral valve surgery. Design A retrospective review. Setting single tertiary referral academic hospital. Participants Two hundred consecutive surgery using da Vinci Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA) at Mayo Clinic Rochester. Interventions None. Measurements and Main Results After obtaining institutional review board approval, surgical data were recorded. For analysis, placed 4 groups, each containing 50 patients, labeled Quartiles 1 4. Over time, there statistically significant decreases cardiopulmonary bypass aortic cross-clamp times. Significant differences management shown, with a reduction intraoperative fentanyl midazolam doses, introduction paravertebral blockade Quartile 2. There time between incision closure extubation, nearly 90% extubated operating room 3 Despite changes analgesic management, focus on earlier no seen visual analog scale (VAS) pain scores over quartiles. Reductions total intensive care unit hospital length stay during period. Conclusions Changes practice, including efforts limit opioid administration addition preoperative blockade, helped facilitate extubation. In second half period, close safely without delaying patient transition unit.