Comparison of intra- and postoperative analgesia and pain perception in robot-assisted vs. open radical prostatectomy
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One of the advantages of minimally invasive surgery may be reduced postoperative pain and faster recovery. However, reliable comparisons of robot-assisted (RARP) vs. open radical prostatectomy (ORP) addressing perioperative pain regimen are scarce.
We identified 420 consecutive treated patients who underwent RARP (n = 254) vs. ORP (n = 166) for clinically localized prostate cancer in 2017. After 1:1 propensity score matching for age, body mass index, D’Amico risk classification and lymph node yield, intra- and postoperative pain medication doses, as well as pain perception expressed by the numeric rating scale were assessed in uni- and multivariable analyses.
Median age was 64.9 years. Operation time was significantly shorter in ORP patients (155 vs. 175 min in RARP, p < 0.001). Overall, a median of 12.5 vs. 12 g of metamizol was administered in RARP vs. ORP patients (p = 0.2). Additionally, a median of 146.7 vs. 133.9 mg of morphine equivalent was administered in RARP vs. ORP patients (p < 0.001). The mean maximum pain perceived on day 0 was 3.2 vs. 3.6 in RARP vs. ORP patients (p = 0.1). It decreased within the following days, and again, no differences between the two groups were observed. All results were confirmed in multivariable analyses.
When comparing RARP vs. ORP, a small increase in perioperative morphine administration at RARP may be expected. However, when assessing pain perception, no differences were observed between the two groups. Moreover, mean maximum pain perceived was very low, which may reassure patients, who are counselled for radical prostatectomy.
KeywordsProstate cancer Morphine equivalent Numeric rating scale Perioperative pain
Protocol/project development: MG, SK. Data collection or management: MH, SK, MS-K. Data analysis: SK, ZT. Manuscript writing/editing: all authors
Compliance with ethical standards
Conflict of interest
There was no external financial support for this study. The authors declare that they have no conflict of interest.
Research involving human participants and/or animals
This article does not contain any studies with human participants performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
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