Back to Search
Start Over
The effect of intrathecal bupivacaine/morphine on quality of recovery in robot-assisted radical prostatectomy: a randomised controlled trial.
- Source :
-
Anaesthesia . May2020, Vol. 75 Issue 5, p599-608. 10p. 1 Diagram, 3 Charts, 1 Graph. - Publication Year :
- 2020
-
Abstract
- Robot-assisted radical prostatectomy causes discomfort in the immediate postoperative period. This randomised controlled trial investigated if intrathecal bupivacaine/morphine, in addition to general anaesthesia, could be beneficial for the postoperative quality of recovery. One hundred and fifty-five patients were randomly allocated to an intervention group that received intrathecal 12.5 mg bupivacaine/300 μg morphine (20% dose reduction in patients > 75 years) or a control group receiving a subcutaneous sham injection and an intravenous loading dose of 0.1 mg.kg-1 morphine. Both groups received standardised general anaesthesia and the same postoperative analgesic regimen. The primary outcome was a decrease in the Quality of Recovery-15 (QoR-15) questionnaire score on postoperative day 1. The intervention group (n = 76) had less reduction in QoR-15 on postoperative day 1; median (IQR [range]) 10% (1-8 [-60% to 50%]) vs. 13% (5-24 [-6% to 50%]), p = 0.019, and used less morphine during the admission; 2 mg (1-7 [0-41 mg]) vs. 15 mg (12-20 [8-61 mg]), p < 0.001. Furthermore, they perceived lower pain scores during exertion; numeric rating scale (NRS) 3 (1-6 [0-9]) vs. 5 (3-7 [0-9]), p = 0.001; less bladder spasms (NRS 1 (0-2 [0-10]) vs. 2 (0-5 [0-10]), p = 0.001 and less sedation; NRS 2 (0-3 [0-10]) vs. 3 (2-6 [0-10]), p = 0.005. Moreover, the intervention group used less rescue medication. Pruritus was more severe in the intervention group; NRS 4 (1-7 [0-10]) vs. 0 (0-1 [0-10]), p = 0.000. We conclude that despite a modest increase in the incidence of pruritus, multimodal pain management with intrathecal bupivacaine/morphine remains a viable option for robot-assisted radical prostatectomy. [ABSTRACT FROM AUTHOR]
- Subjects :
- *PROSTATECTOMY
*BUPIVACAINE
*MORPHINE
*SPINAL infusions
*INTRAVENOUS injections
*POSTOPERATIVE period
*PAIN management
*RESEARCH
*FERRANS & Powers Quality of Life Index
*SPINAL injections
*GENERAL anesthesia
*PAIN measurement
*ANESTHESIA
*SURGICAL robots
*RESEARCH methodology
*SURGICAL complications
*EVALUATION research
*MEDICAL cooperation
*TREATMENT effectiveness
*COMPARATIVE studies
*RANDOMIZED controlled trials
*ITCHING
*QUESTIONNAIRES
*SPINAL anesthesia
*LOCAL anesthetics
Subjects
Details
- Language :
- English
- ISSN :
- 00032409
- Volume :
- 75
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- Anaesthesia
- Publication Type :
- Academic Journal
- Accession number :
- 142689989
- Full Text :
- https://doi.org/10.1111/anae.14922