Pain and Analgesic Use After Robot-Assisted Radical Prostatectomy
Pain and Analgesic Use After Robot-Assisted Radical Prostatectomy
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DOI：
10.1089/end.2013.0783
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发表时间：
2014-05-01
影响因子：
2.7
通讯作者：
Badani, Ketan K.
中科院分区：
文献类型：
--
作者：
Woldu, Solomon L.;Weinberg, Aaron C.;Badani, Ketan K.
目的：虽然机器人辅助根治性直肠癌切除术（RARP）与开放性直肠癌切除术相比可缩短恢复期和减少失血量，但关于RARP后的术后疼痛/不适和镇痛药物使用的客观数据很少。我们试图检查这些参数在当代coherent.Patients和方法：从2011年到2013年，接受RARP的患者前瞻性地参加了一项研究，检查各种疼痛参数，并仔细监测阿片类药物和其他镇痛药物的使用，而病人在医院恢复。出院后，患者被要求填写一份关于他们的疼痛参数和自我报告的阿片类药物使用情况的每日问卷。所有问卷均基于Wong-Baker FACES疼痛评分量表（0 - 10）。阿片类药物剂量转换为近似的口服硫酸吗啡等效剂量（MSE）。结果：共有60例患者，平均年龄61岁，参加了这项研究，进行RARP，并完成了随访问卷。没有人有慢性麻醉剂使用史。术中阿片类药物使用为94.1 mg MSE。有73.3%的患者术后立即接受酮咯酸治疗。RARP后，疼痛/不适的主要来源是腹部/切口，其次是导尿管相关、阴茎和膀胱痉挛相关不适。大多数患者的腹痛一般为中度，约4天后明显减轻。在整个研究期间，阴茎和尿道导管相关不适为轻度。阿片类镇痛药物的使用迅速下降的主观疼痛scoresimproved.Conclusions：RARP后，大多数患者出现轻度/中度腹部不适，这在几天内稳步改善。阿片类止痛药的平均使用也迅速下降，这与疼痛症状的主观改善相对应。这些信息对于临床医生就RARP相关疼痛向患者提供咨询是有用的，并且可以作为参考，以比较与局限性前列腺癌患者治疗的其他选择相关的恢复期。
Purpose: While robot-assisted radical prostatectomy (RARP) is associated with shortened convalescence and decreased blood loss over open prostatectomy, little objective data is available regarding postoperative pain/discomfort and use of analgesic medications after RARP. We sought to examine these parameters in a contemporary cohort.Patients and Methods: From 2011 to 2013, patients undergoing RARP were prospectively enrolled in a study to examine various pain parameters and carefully monitor opiate and other analgesic medication use while the patient recovered in the hospital. After discharge, the patients were asked to fill out a daily questionnaire regarding their pain parameters and self-report opiate usage. All questionnaires were based on the Wong-Baker FACES pain rating scale (0-10). Opiate dosages were converted to the approximate oral morphine sulfate equivalent dose (MSE).Results: A total of 60 patients, mean age 61 years, were enrolled in the study, underwent RARP, and completed follow-up questionnaires. None had a history of chronic narcotic use. Intraoperative opiate use was 94.1 mg MSE. There were 73.3% who received immediate postoperative ketorolac. After RARP, the main source of pain/discomfort was abdominal/incisional, followed by urethral catheter-related, penile, and bladder spasm-related discomfort. Abdominal pain was generally moderate for most patients and decreased significantly after about 4 days. Penile and urethral catheter-related discomfort was mild throughout the study period. Opiate analgesic medication use quickly decreased as the subjective pain scores improved.Conclusions: After RARP, most patients experience mild/moderate abdominal discomfort, which improves steadily over several days. There is also a quick decline in the average opiate pain medication use that corresponds to the subjective improvement in pain symptoms. This information is useful for clinicians counseling patients on the pain associated with RARP and can serve as a reference to compare the convalescence associated with the other options for treatment of patients with localized prostate cancer.