Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPSABA, Gabriela TogniniQUINTÃO, Vinicius CaldeiraZEFERINO, Suely PereiraSIMÕES, Claudia MarquezCOELHO, Rafael FerreiraFAZOLI, ArnaldoNAHAS, WilliamVILELA, Gustavo Henrique FrigieriCARMONA, Maria José Carvalho2022-03-092022-03-092021BRAZILIAN JOURNAL OF ANESTHESIOLOGY, v.71, n.6, p.656-659, 20212352-2291https://observatorio.fm.usp.br/handle/OPI/44821Abstract Both robotic surgery and head-down tilt increase intracranial pressure by impairing venous blood outflow. Prostatectomy is commonly performed in elderly patients, who are more likely to develop postoperative cognitive disorders. Therefore, increased intracranial pressure could play an essential role in cognitive decline after surgery. We describe a case of a 69-year-old male who underwent a robotic prostatectomy. Noninvasive Brain4care™ intraoperative monitoring showed normal intracranial compliance during anesthesia induction, but it rapidly decreased after head-down tilt despite normal vital signs, low lung pressure, and adequate anesthesia depth. We conclude that there is a need for intraoperative intracranial compliance monitoring since there are major changes in cerebral compliance during surgery, which could potentially allow early identification and treatment of impaired cerebral complacency.engopenAccessHead-down tiltIntracranial pressureRobotic surgical proceduresarticleCopyright Sociedade Brasileira de Anestesiologia (SBA)10.1016/j.bjane.2021.09.003AnesthesiologyMedicine, General & Internal