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A retrospective comparison of anesthetic management of robot-assisted laparoscopic radical prostatectomy versus radical retropubic prostatectomy.
J Clin Anesth. 2009 Aug; 21(5):322-8.JC

Abstract

STUDY OBJECTIVE

To compare anesthetic management and postoperative outcomes in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALP) and radical retropubic prostatectomy (RRP) with general anesthesia.

DESIGN

Retrospective database study of RALP and RRP patients at Duke University Medical Center from 6/2003 to 6/2006.

SETTING

University teaching hospital.

PATIENTS

541 ASA physical status I, II, and III men, 280 of whom were RRP patients and 256 RALP patients.

MEASUREMENTS

Patient demographics, intraoperative fluids and blood products, hemodynamic parameters, pain scores in the Postanesthesia Care Unit (PACU), intraoperative and postoperative analgesic consumption, need for rescue antiemetics in the PACU, and intraoperative use of vasopressors and antihypertensives, were all recorded. Additional data included postoperative transfusion data; clinical status of the patient's cancer preoperatively and postoperatively; hematocrit, platelet count, and creatinine levels; and length of hospital stay.

MAIN RESULTS

Estimated blood loss (EBL) was higher for RRP than RALP patients (mean +/- SD; 1,087 +/- 853 mL vs. 287 +/- 317 mL; P < 0.0001). Likewise, 24% of RRP patients received red blood cell (RBC) transfusions intraoperatively, compared with 0.4% RALP patients (P < 0.0001). Intraoperatively, RALP patients received more antihypertensive agents (37% vs. 21%; P < 0.0001), and fewer vasopressors (63% vs. 78%; P < 0.0001) than did RRP patients. The two groups had similar morphine-equivalent opioid use intraoperatively, but in the PACU, RALP patients required fewer morphine equivalents (mean +/- SD; 11.4 +/- 7.7 mg vs. 14.9 +/- 9.8 mg; P < 0.0001). The RALP patients had longer surgical times (mean +/- SD; 296 +/- 76 vs.193 +/- 69 min; P < 0.0001) but shorter PACU stays (mean +/- SD; 113 +/- 55 min vs. 143 +/- 58 min; P < 0.0001) and shorter hospital stays (mean +/- SD; 44 +/- 77 hrs vs. 56 +/- 26 hrs; P = 0.009).

CONCLUSIONS

Duration of surgery was greater with RALP, but it was associated with less EBL, fewer transfusions of blood products, and shorter PACU and hospital stays.

Authors+Show Affiliations

Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19700296

Citation

D'Alonzo, Richard C., et al. "A Retrospective Comparison of Anesthetic Management of Robot-assisted Laparoscopic Radical Prostatectomy Versus Radical Retropubic Prostatectomy." Journal of Clinical Anesthesia, vol. 21, no. 5, 2009, pp. 322-8.
D'Alonzo RC, Gan TJ, Moul JW, et al. A retrospective comparison of anesthetic management of robot-assisted laparoscopic radical prostatectomy versus radical retropubic prostatectomy. J Clin Anesth. 2009;21(5):322-8.
D'Alonzo, R. C., Gan, T. J., Moul, J. W., Albala, D. M., Polascik, T. J., Robertson, C. N., Sun, L., Dahm, P., & Habib, A. S. (2009). A retrospective comparison of anesthetic management of robot-assisted laparoscopic radical prostatectomy versus radical retropubic prostatectomy. Journal of Clinical Anesthesia, 21(5), 322-8. https://doi.org/10.1016/j.jclinane.2008.09.005
D'Alonzo RC, et al. A Retrospective Comparison of Anesthetic Management of Robot-assisted Laparoscopic Radical Prostatectomy Versus Radical Retropubic Prostatectomy. J Clin Anesth. 2009;21(5):322-8. PubMed PMID: 19700296.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A retrospective comparison of anesthetic management of robot-assisted laparoscopic radical prostatectomy versus radical retropubic prostatectomy. AU - D'Alonzo,Richard C, AU - Gan,Tong J, AU - Moul,Judd W, AU - Albala,David M, AU - Polascik,Thomas J, AU - Robertson,Cary N, AU - Sun,Leon, AU - Dahm,Philipp, AU - Habib,Ashraf S, Y1 - 2009/08/22/ PY - 2007/09/12/received PY - 2008/08/27/revised PY - 2008/09/04/accepted PY - 2009/8/25/entrez PY - 2009/8/25/pubmed PY - 2009/11/18/medline SP - 322 EP - 8 JF - Journal of clinical anesthesia JO - J Clin Anesth VL - 21 IS - 5 N2 - STUDY OBJECTIVE: To compare anesthetic management and postoperative outcomes in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALP) and radical retropubic prostatectomy (RRP) with general anesthesia. DESIGN: Retrospective database study of RALP and RRP patients at Duke University Medical Center from 6/2003 to 6/2006. SETTING: University teaching hospital. PATIENTS: 541 ASA physical status I, II, and III men, 280 of whom were RRP patients and 256 RALP patients. MEASUREMENTS: Patient demographics, intraoperative fluids and blood products, hemodynamic parameters, pain scores in the Postanesthesia Care Unit (PACU), intraoperative and postoperative analgesic consumption, need for rescue antiemetics in the PACU, and intraoperative use of vasopressors and antihypertensives, were all recorded. Additional data included postoperative transfusion data; clinical status of the patient's cancer preoperatively and postoperatively; hematocrit, platelet count, and creatinine levels; and length of hospital stay. MAIN RESULTS: Estimated blood loss (EBL) was higher for RRP than RALP patients (mean +/- SD; 1,087 +/- 853 mL vs. 287 +/- 317 mL; P < 0.0001). Likewise, 24% of RRP patients received red blood cell (RBC) transfusions intraoperatively, compared with 0.4% RALP patients (P < 0.0001). Intraoperatively, RALP patients received more antihypertensive agents (37% vs. 21%; P < 0.0001), and fewer vasopressors (63% vs. 78%; P < 0.0001) than did RRP patients. The two groups had similar morphine-equivalent opioid use intraoperatively, but in the PACU, RALP patients required fewer morphine equivalents (mean +/- SD; 11.4 +/- 7.7 mg vs. 14.9 +/- 9.8 mg; P < 0.0001). The RALP patients had longer surgical times (mean +/- SD; 296 +/- 76 vs.193 +/- 69 min; P < 0.0001) but shorter PACU stays (mean +/- SD; 113 +/- 55 min vs. 143 +/- 58 min; P < 0.0001) and shorter hospital stays (mean +/- SD; 44 +/- 77 hrs vs. 56 +/- 26 hrs; P = 0.009). CONCLUSIONS: Duration of surgery was greater with RALP, but it was associated with less EBL, fewer transfusions of blood products, and shorter PACU and hospital stays. SN - 1873-4529 UR - https://www.unboundmedicine.com/medline/citation/19700296/A_retrospective_comparison_of_anesthetic_management_of_robot_assisted_laparoscopic_radical_prostatectomy_versus_radical_retropubic_prostatectomy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0952-8180(09)00106-8 DB - PRIME DP - Unbound Medicine ER -