Robotic-Assisted Laparoscopic Prostatectomy under Thoracic Spinal Anesthesia: An Effective Alternative

Abstract

This case report describes a successful use of Thoracic Spinal Anesthesia (TSA) for a 74-year-old patient undergoing Robotic-Assisted Laparoscopic Prostatectomy (RALP). The patient was in good health with an ASA I status and had a mixture of hyperbaric,hypobaric, and adjunctive anesthetic agents, including atropine,dexmedetomidine, and dexamethasone, injected at the T7-T8 level. The patient achieved sufficient anesthesia for the entire surgical procedure with associated sedation, spontaneous breathing, intense postoperative pain control without residual motor blockade.The surgical incision was performed 20 minutes after the spinal puncture, and the patient did not have any reaction. The patient achieved a wakeful sedation after 10 minutes. The robot was used for prostate removal, followed by hemostasis and urethral anastomosis. The console time was 80 minutes. At the end of intervention, the patient had no perception of what occurred. Early feeding,bowel movements and mobilitazion were observed. The analgesic effect prolonged until the following day.