Effectiveness of the Molloy Bridgeport Observation Scale in Predicting Increased Intraocular Pressure During da Vinci Robotic Procedures

2.50
Hdl Handle:
http://hdl.handle.net/10755/335361
Category:
Full-text
Type:
Presentation
Title:
Effectiveness of the Molloy Bridgeport Observation Scale in Predicting Increased Intraocular Pressure During da Vinci Robotic Procedures
Author(s):
Livingston, LaDean J.; Alexandrov, Anne Wojner
Lead Author STTI Affiliation:
Nu
Author Details:
LaDean J. Livingston, DNP, CRNA, llivingston@umc.edu, ladeanjohnson@earthlink.net; Anne Wojner Alexandrov, PhD, RN, CCRN, FAAN
Abstract:
Session Presented on Friday, July 25, 2014: Background and purpose: Postoperative vision loss (POVL) has been associated with increased intraocular pressure (IOP) resulting in decreased retinal perfusion during 15-30 Trendelenburg positioning for abdominal da Vinci robotic procedures. The Molloy Bridge Observation Scale (MBOS) has been suggested as a method for anesthesia providers to recognize the signs of increased IOP without use of an expensive tonometry unit; however, the generalizability of this method has not been studied in a large number of centers. Therefore, we aim to assess the comparative effectiveness of the MBOS in relation to tonometry readings to determine the presence of increased IOP. Methods/Purpose: Institutional Review Board approval is underway for the conduct of a prospective observational study that will serially compare use of the MBOS to actual tonometry readings in patients undergoing abdominal surgery using the da Vinci robot. Consecutive cases will be enrolled that meet the following inclusion criteria: Age > 19 years, and elective abdominal surgery using the da Vinci robot. Subjects with a history of glaucoma will be excluded. Concurrent measures will be taken by two investigators blinded to each other's findings, with one performing an assessment using the MBOS and the principal investigator measuring actual tonometry pressures every 30 minutes for the duration of Trendelenberg positioning. A surgical 'time out' will occur with the patient returned to 0o HOB elevation, if IOP exceeds 40 mm Hg. This is a documented measure at which blood flow to the ocular nerve has ceased, potentially causing ischemic nerve damage. Data will be entered/analyzed in SPSS. Results: This study is awaiting IRB approval with an anticipated start date of Summer2014. Conclusion: While use of the da Vinci robot has revolutionized the approach to a number of surgical procedures, increased IOP is an unfortunate associated finding. This study will allow for comparative assessment of the effectiveness of 2 approaches that aim to reduce the risk of POVL in this patient population.
Keywords:
da Vinci robot; position and time; steep trendelenburg
Repository Posting Date:
17-Nov-2014
Date of Publication:
17-Nov-2014 ; 17-Nov-2014
Other Identifiers:
INRC14PST17
Conference Date:
2014
Conference Name:
25th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Hong Kong
Description:
International Nursing Research Congress, 2014 Theme: Engaging Colleagues: Improving Global Health Outcomes. Held at the Hong Kong Convention and Exhibition Centre, Wanchai, Hong Kong

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.language.isoenen
dc.type.categoryFull-texten
dc.typePresentationen
dc.titleEffectiveness of the Molloy Bridgeport Observation Scale in Predicting Increased Intraocular Pressure During da Vinci Robotic Proceduresen
dc.contributor.authorLivingston, LaDean J.en
dc.contributor.authorAlexandrov, Anne Wojneren
dc.contributor.departmentNuen
dc.author.detailsLaDean J. Livingston, DNP, CRNA, llivingston@umc.edu, ladeanjohnson@earthlink.net; Anne Wojner Alexandrov, PhD, RN, CCRN, FAANen
dc.identifier.urihttp://hdl.handle.net/10755/335361-
dc.description.abstractSession Presented on Friday, July 25, 2014: Background and purpose: Postoperative vision loss (POVL) has been associated with increased intraocular pressure (IOP) resulting in decreased retinal perfusion during 15-30 Trendelenburg positioning for abdominal da Vinci robotic procedures. The Molloy Bridge Observation Scale (MBOS) has been suggested as a method for anesthesia providers to recognize the signs of increased IOP without use of an expensive tonometry unit; however, the generalizability of this method has not been studied in a large number of centers. Therefore, we aim to assess the comparative effectiveness of the MBOS in relation to tonometry readings to determine the presence of increased IOP. Methods/Purpose: Institutional Review Board approval is underway for the conduct of a prospective observational study that will serially compare use of the MBOS to actual tonometry readings in patients undergoing abdominal surgery using the da Vinci robot. Consecutive cases will be enrolled that meet the following inclusion criteria: Age > 19 years, and elective abdominal surgery using the da Vinci robot. Subjects with a history of glaucoma will be excluded. Concurrent measures will be taken by two investigators blinded to each other's findings, with one performing an assessment using the MBOS and the principal investigator measuring actual tonometry pressures every 30 minutes for the duration of Trendelenberg positioning. A surgical 'time out' will occur with the patient returned to 0o HOB elevation, if IOP exceeds 40 mm Hg. This is a documented measure at which blood flow to the ocular nerve has ceased, potentially causing ischemic nerve damage. Data will be entered/analyzed in SPSS. Results: This study is awaiting IRB approval with an anticipated start date of Summer2014. Conclusion: While use of the da Vinci robot has revolutionized the approach to a number of surgical procedures, increased IOP is an unfortunate associated finding. This study will allow for comparative assessment of the effectiveness of 2 approaches that aim to reduce the risk of POVL in this patient population.en
dc.subjectda Vinci roboten
dc.subjectposition and timeen
dc.subjectsteep trendelenburgen
dc.date.available2014-11-17T13:50:35Z-
dc.date.issued2014-11-17-
dc.date.issued2014-11-17en
dc.date.accessioned2014-11-17T13:50:35Z-
dc.conference.date2014en
dc.conference.name25th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationHong Kongen
dc.descriptionInternational Nursing Research Congress, 2014 Theme: Engaging Colleagues: Improving Global Health Outcomes. Held at the Hong Kong Convention and Exhibition Centre, Wanchai, Hong Kongen
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.