A 68-Year-Old,American Society of Anesthesiologists (ASA)physical Status (PS)-2 Male with Early-Stage

Multiple Choice

A 68-year-old,American Society of Anesthesiologists (ASA) physical status (PS) -2 male with early-stage prostatic cancer,was intubated and positioned for a robotic-assisted laparoscopic radical prostatectomy.The initial position for insertion of the trocars was supine with arms tucked and secured within under-mattress sled arm positioners padded with gel.His hands were placed in a natural position with the fingers wrapped around gauze rolls and touching his lateral thighs.The new anesthesia provider,who had never seen a robotic prostatectomy,was concerned about anesthesia implications when the patient would be repositioned into extreme Trendelenburg for the dissection and anastomosis.The circulating nurse assured her that they would implement protective measures and work together to ensure the best patient outcome.Select all of the potentially harmful effects of extreme 45-degree Trendelenburg in a robotic procedure.

A) Respiratory compromise and ventilation resistance
B) Pelvic pressure from abdominal organs
C) Shearing injury to soft tissues
D) Heel pressure injury from stirrup boot