Effect of Surgery in the Steep Trendelenburg Position on Blood Pressure Stability of the Elderly Candidate for Open Radical Prostatectomy: A Randomized Controlled Clinical Trial

The stability of blood pressure and maintaining the cerebral perfusion pressure are of particular importance in anesthesia of the elderly. There is scant clinical trials on the advantages of the steep Trendelenburg position in prostatectomy. This study aims to evaluate the effect of surgery in the steep Trendelenburg position on blood pressure stability of the elderly candidate for open radical prostatectomy surgery.

This randomized controlled clinical trial was conducted at Shahid Beheshti Hospital in Hamadan, Iran, in 2022. Sixty older adults candidates for elective open radical prostatectomy were selected by a convenience sampling method and randomly allocated to the steep Trendelenburg position and supine position groups. Patients in the first group were in a 15° steep Trendelenburg position before surgery. Patients in the second position group remained in the supine position during surgery. The mean systolic and diastolic blood pressures were assessed after anesthesia, after positioning, and during surgery at 30-min intervals. The data were analyzed in SPSS software, vertion 22 using independent t-test and repeated measures ANOVA.

The mean age of the patients was 60.9±4.2 years, and their mean body mass index was 24.7±3.5 kg/m2. There was no significant difference in the mean systolic and diastolic blood pressures between the two groups (P>0.05). The results of repeated measures ANOVA showed that the differences in the mean systolic and diastolic blood pressures were statistically significant among the evaluation times (P<0.001).

The steep Trendelenburg position maintains the blood pressure of the elderly under open radical prostatectomy.