دورية أكاديمية
Intraoperative Strategies to Reduce Catheter-Related Bladder Discomfort in the Early Postoperative Period after Robot-Assisted Radical Prostatectomy.
| العنوان: | Intraoperative Strategies to Reduce Catheter-Related Bladder Discomfort in the Early Postoperative Period after Robot-Assisted Radical Prostatectomy. |
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| المؤلفون: | Veerman H; Department of Urology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.; Department of Urology, Amsterdam University Medical Centers, Amsterdam, the Netherlands.; Prostate Cancer Network Netherlands, Amsterdam, the Netherlands., Houwink API; Department of Anesthesiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands., Schutte PFE; Department of Anesthesiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands., Nieuwenhuijzen JA; Department of Urology, Amsterdam University Medical Centers, Amsterdam, the Netherlands.; Prostate Cancer Network Netherlands, Amsterdam, the Netherlands., Roeleveld TA; Prostate Cancer Network Netherlands, Amsterdam, the Netherlands.; Department of Urology, Noord-West Ziekenhuis, Den Helder, the Netherlands., Wit E; Department of Urology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.; Prostate Cancer Network Netherlands, Amsterdam, the Netherlands., Mazel JW; Prostate Cancer Network Netherlands, Amsterdam, the Netherlands.; Department of Urology, Spaarne Gasthuis, Hoofddorp, the Netherlands., van der Sluis TM; Department of Urology, Amsterdam University Medical Centers, Amsterdam, the Netherlands.; Prostate Cancer Network Netherlands, Amsterdam, the Netherlands., Vis AN; Department of Urology, Amsterdam University Medical Centers, Amsterdam, the Netherlands.; Prostate Cancer Network Netherlands, Amsterdam, the Netherlands., van Leeuwen PJ; Department of Urology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.; Prostate Cancer Network Netherlands, Amsterdam, the Netherlands., van der Poel HG; Department of Urology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.; Prostate Cancer Network Netherlands, Amsterdam, the Netherlands. |
| المصدر: | The Journal of urology [J Urol] 2021 Jun; Vol. 205 (6), pp. 1671-1680. Date of Electronic Publication: 2021 Feb 19. |
| نوع المنشور: | Comparative Study; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wolters Kluwer Country of Publication: United States NLM ID: 0376374 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-3792 (Electronic) Linking ISSN: 00225347 NLM ISO Abbreviation: J Urol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2019- : [Philadelphia, PA] : Wolters Kluwer Original Publication: Baltimore : Lippincott Williams & Wilkins |
| مواضيع طبية MeSH: | Prostatectomy*/methods , Robotic Surgical Procedures* , Urinary Bladder*, Intraoperative Care/*methods , Pain, Procedural/*etiology , Pain, Procedural/*prevention & control , Postoperative Complications/*etiology , Postoperative Complications/*prevention & control , Urinary Catheters/*adverse effects, Aged ; Aged, 80 and over ; Anesthesia, General ; Humans ; Male ; Middle Aged ; Nerve Block ; Prospective Studies ; Time Factors |
| مستخلص: | Purpose: Catheter-related bladder discomfort occurs in up to 63% of patients following robot-assisted radical prostatectomy. The optimal intraoperative anesthesia regime to prevent patients from catheter-related bladder discomfort is unknown. Materials and Methods: A prospective cohort analysis was conducted. Patients with biopsy-proven prostate cancer selected for robot-assisted radical prostatectomy were included between January 2017 and April 2020 from a high volume prostate cancer center. Eight different treatment regimens were compared, ie a combination of general anesthesia and a transversus abdominis plane block with either an additional dose of clonidine or an additional dose of ketamine, or perivesical infiltrations (with 20 ml ropivacaine), or periurethral infiltrations (with ropivacaine); or a dorsal penile nerve block (with 20 ml ropivacaine). Multiple logistic regression and linear mixed models were used to analyze differences in catheter-related bladder discomfort and pain (0-10) at the postoperative recovery unit between the treatment protocols. Results: Of the 391 patients included, those with a combination transversus abdominis plane block, perivesical and periurethral block with ropivacaine had the lowest incidence of catheter-related bladder discomfort, clinically relevant and statistically significantly lower compared to our baseline protocol (transversus abdominis plane block only), ie 36% vs 70%, p=0.001. Overall, patients who were treated with periurethral and/or perivesical infiltrations reported a statistically significantly lower incidence of catheter-related bladder discomfort compared to patients who did not receive this local infiltration (46.5% vs 60.7%, p=0.001). Conclusions: Perivesical and periurethral injections with ropivacaine have the potential to reduce the incidence of early postoperative catheter-related bladder discomfort by up to 49%. Further randomized studies are necessary to determine the optimal treatment regime to prevent early postoperative catheter-related bladder discomfort. |
| التعليقات: | Comment in: J Urol. 2021 Jun;205(6):1679-1680. (PMID: 33734853) Erratum in: J Urol. 2022 Jan;207(1):250. (PMID: 34879763) |
| فهرسة مساهمة: | Keywords: prostatectomy, prostatic neoplasms, pain, micturition, analgesics |
| تواريخ الأحداث: | Date Created: 20210219 Date Completed: 20210715 Latest Revision: 20211209 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1097/JU.0000000000001645 |
| PMID: | 33605794 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1527-3792 |
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| DOI: | 10.1097/JU.0000000000001645 |