Evaluation of analgesic requirements and postoperative recovery after radical retropubic prostatectomy using long-acting spinal anesthesia

Paul D. Sved, Alan M. Nieder, Murugesan Manoharan, Pablo Gomez, David S. Meinbach, Sandy S. Kim, Mark S. Soloway

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objectives. To analyze the postoperative pain, analgesic requirements, and convalescence of patients undergoing radical retropubic prostatectomy (RRP) under spinal anesthesia using long-acting morphine sulfate as preemptive analgesia. Methods. A total of 103 consecutive men underwent RRP by a single surgeon. The time to tolerate oral fluids, time to unassisted ambulation, postoperative pain levels (visual analog pain score of 0 to 10), and analgesic requirements expressed in morphine equivalents were evaluated. Baseline patient characteristics and intraoperative factors (operating room time, blood loss) were also evaluated. Results. The mean time to tolerate oral fluids and unassisted ambulation was 11.3 ± 7.6 hours and 20 ± 6 hours, respectively. The mean narcotic requirements were 7.4 ± 6.1 morphine equivalents before discharge and 28.5 ± 25.9 morphine equivalents in the first week after discharge. The mean visual analog pain score was 4.5 ± 2.1 at discharge and fell significantly to 1.5 ± 1.0 by the time of Foley catheter removal on postoperative day 7 or 8. The analgesic requirements after discharge correlated with the pain score at discharge (P = 0.016). The mean time to resumption of normal preoperative activities was 19.4 ± 9.4 days. Two patients developed postspinal anesthesia headache. No other complications attributable to the anesthetic occurred. Conclusions. RRP may be performed through a small modified Pfannenstiel incision under spinal anesthesia containing long-acting morphine with little postoperative pain, low narcotic requirements, and a short convalescence. A prospective, randomized study is needed to compare the early postoperative outcomes of RRP performed using general versus spinal anesthesia.

Original languageEnglish
Pages (from-to)509-512
Number of pages4
JournalUrology
Volume65
Issue number3
DOIs
StatePublished - Mar 1 2005

Fingerprint

Spinal Anesthesia
Prostatectomy
Analgesics
Morphine
Postoperative Pain
Narcotics
Pain
Walking
Operating Rooms
Analgesia
Headache
Anesthetics
Catheters
Anesthesia
Prospective Studies

ASJC Scopus subject areas

  • Urology

Cite this

Sved, P. D., Nieder, A. M., Manoharan, M., Gomez, P., Meinbach, D. S., Kim, S. S., & Soloway, M. S. (2005). Evaluation of analgesic requirements and postoperative recovery after radical retropubic prostatectomy using long-acting spinal anesthesia. Urology, 65(3), 509-512. https://doi.org/10.1016/j.urology.2004.09.063

Evaluation of analgesic requirements and postoperative recovery after radical retropubic prostatectomy using long-acting spinal anesthesia. / Sved, Paul D.; Nieder, Alan M.; Manoharan, Murugesan; Gomez, Pablo; Meinbach, David S.; Kim, Sandy S.; Soloway, Mark S.

In: Urology, Vol. 65, No. 3, 01.03.2005, p. 509-512.

Research output: Contribution to journalArticle

Sved, Paul D. ; Nieder, Alan M. ; Manoharan, Murugesan ; Gomez, Pablo ; Meinbach, David S. ; Kim, Sandy S. ; Soloway, Mark S. / Evaluation of analgesic requirements and postoperative recovery after radical retropubic prostatectomy using long-acting spinal anesthesia. In: Urology. 2005 ; Vol. 65, No. 3. pp. 509-512.
@article{4ca47916fa4845e8857bd80cb57c1e73,
title = "Evaluation of analgesic requirements and postoperative recovery after radical retropubic prostatectomy using long-acting spinal anesthesia",
abstract = "Objectives. To analyze the postoperative pain, analgesic requirements, and convalescence of patients undergoing radical retropubic prostatectomy (RRP) under spinal anesthesia using long-acting morphine sulfate as preemptive analgesia. Methods. A total of 103 consecutive men underwent RRP by a single surgeon. The time to tolerate oral fluids, time to unassisted ambulation, postoperative pain levels (visual analog pain score of 0 to 10), and analgesic requirements expressed in morphine equivalents were evaluated. Baseline patient characteristics and intraoperative factors (operating room time, blood loss) were also evaluated. Results. The mean time to tolerate oral fluids and unassisted ambulation was 11.3 ± 7.6 hours and 20 ± 6 hours, respectively. The mean narcotic requirements were 7.4 ± 6.1 morphine equivalents before discharge and 28.5 ± 25.9 morphine equivalents in the first week after discharge. The mean visual analog pain score was 4.5 ± 2.1 at discharge and fell significantly to 1.5 ± 1.0 by the time of Foley catheter removal on postoperative day 7 or 8. The analgesic requirements after discharge correlated with the pain score at discharge (P = 0.016). The mean time to resumption of normal preoperative activities was 19.4 ± 9.4 days. Two patients developed postspinal anesthesia headache. No other complications attributable to the anesthetic occurred. Conclusions. RRP may be performed through a small modified Pfannenstiel incision under spinal anesthesia containing long-acting morphine with little postoperative pain, low narcotic requirements, and a short convalescence. A prospective, randomized study is needed to compare the early postoperative outcomes of RRP performed using general versus spinal anesthesia.",
author = "Sved, {Paul D.} and Nieder, {Alan M.} and Murugesan Manoharan and Pablo Gomez and Meinbach, {David S.} and Kim, {Sandy S.} and Soloway, {Mark S.}",
year = "2005",
month = "3",
day = "1",
doi = "10.1016/j.urology.2004.09.063",
language = "English",
volume = "65",
pages = "509--512",
journal = "Urology",
issn = "0090-4295",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Evaluation of analgesic requirements and postoperative recovery after radical retropubic prostatectomy using long-acting spinal anesthesia

AU - Sved, Paul D.

AU - Nieder, Alan M.

AU - Manoharan, Murugesan

AU - Gomez, Pablo

AU - Meinbach, David S.

AU - Kim, Sandy S.

AU - Soloway, Mark S.

PY - 2005/3/1

Y1 - 2005/3/1

N2 - Objectives. To analyze the postoperative pain, analgesic requirements, and convalescence of patients undergoing radical retropubic prostatectomy (RRP) under spinal anesthesia using long-acting morphine sulfate as preemptive analgesia. Methods. A total of 103 consecutive men underwent RRP by a single surgeon. The time to tolerate oral fluids, time to unassisted ambulation, postoperative pain levels (visual analog pain score of 0 to 10), and analgesic requirements expressed in morphine equivalents were evaluated. Baseline patient characteristics and intraoperative factors (operating room time, blood loss) were also evaluated. Results. The mean time to tolerate oral fluids and unassisted ambulation was 11.3 ± 7.6 hours and 20 ± 6 hours, respectively. The mean narcotic requirements were 7.4 ± 6.1 morphine equivalents before discharge and 28.5 ± 25.9 morphine equivalents in the first week after discharge. The mean visual analog pain score was 4.5 ± 2.1 at discharge and fell significantly to 1.5 ± 1.0 by the time of Foley catheter removal on postoperative day 7 or 8. The analgesic requirements after discharge correlated with the pain score at discharge (P = 0.016). The mean time to resumption of normal preoperative activities was 19.4 ± 9.4 days. Two patients developed postspinal anesthesia headache. No other complications attributable to the anesthetic occurred. Conclusions. RRP may be performed through a small modified Pfannenstiel incision under spinal anesthesia containing long-acting morphine with little postoperative pain, low narcotic requirements, and a short convalescence. A prospective, randomized study is needed to compare the early postoperative outcomes of RRP performed using general versus spinal anesthesia.

AB - Objectives. To analyze the postoperative pain, analgesic requirements, and convalescence of patients undergoing radical retropubic prostatectomy (RRP) under spinal anesthesia using long-acting morphine sulfate as preemptive analgesia. Methods. A total of 103 consecutive men underwent RRP by a single surgeon. The time to tolerate oral fluids, time to unassisted ambulation, postoperative pain levels (visual analog pain score of 0 to 10), and analgesic requirements expressed in morphine equivalents were evaluated. Baseline patient characteristics and intraoperative factors (operating room time, blood loss) were also evaluated. Results. The mean time to tolerate oral fluids and unassisted ambulation was 11.3 ± 7.6 hours and 20 ± 6 hours, respectively. The mean narcotic requirements were 7.4 ± 6.1 morphine equivalents before discharge and 28.5 ± 25.9 morphine equivalents in the first week after discharge. The mean visual analog pain score was 4.5 ± 2.1 at discharge and fell significantly to 1.5 ± 1.0 by the time of Foley catheter removal on postoperative day 7 or 8. The analgesic requirements after discharge correlated with the pain score at discharge (P = 0.016). The mean time to resumption of normal preoperative activities was 19.4 ± 9.4 days. Two patients developed postspinal anesthesia headache. No other complications attributable to the anesthetic occurred. Conclusions. RRP may be performed through a small modified Pfannenstiel incision under spinal anesthesia containing long-acting morphine with little postoperative pain, low narcotic requirements, and a short convalescence. A prospective, randomized study is needed to compare the early postoperative outcomes of RRP performed using general versus spinal anesthesia.

UR - http://www.scopus.com/inward/record.url?scp=15244355894&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=15244355894&partnerID=8YFLogxK

U2 - 10.1016/j.urology.2004.09.063

DO - 10.1016/j.urology.2004.09.063

M3 - Article

VL - 65

SP - 509

EP - 512

JO - Urology

JF - Urology

SN - 0090-4295

IS - 3

ER -