Jeremie Abitbol1, Rebecca Cohn1, Sandra Hunter2, Marcelo Rombaldi1, Eva Cohen3, Roy Kessous1, Nick Large3, Ari Reiss1, Susie Lau1, Shannon Salvador1, Walter H Gotlieb4. 1. Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada. 2. Pain Management Division of Surgery, Jewish General Hospital, McGill University, Montreal, Quebec, Canada. 3. Pharmacy Department, Lady Davis Institute of Research, Jewish General Hospital, McGill University, Montreal, Quebec, Canada. 4. Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada. Electronic address: walter.gotlieb@mcgill.ca.
Abstract
INTRODUCTION: Minimally invasive surgery (MIS) has been associated with diminished postoperative pain and analgesia requirements. The objective of the current study was to evaluate the use of analgesia in the post-operative period following robotic surgery for endometrial cancer. METHODS: All consecutive patients who underwent robotic surgery for the treatment of endometrial cancer were included in this study. The timing, dose, and type of analgesics administered postoperatively were recorded from patients' electronic medical record. Data was compared to a matched historical cohort of patients who underwent laparotomy before the introduction of the robotic program. RESULTS: Only eight patients (2.4%, 5 during the first 25 cases and 3 following mini-laparotomy) received patient-controlled analgesia (PCA) following robotic surgery. Most patients' pain was alleviated by over-the-counter analgesics (acetaminophen, non-steroidal anti-inflammatories). In comparison to laparotomy, patients who underwent robotic surgery required significantly less opioids (71mg vs. 12mg IV morphine, p<0.0001) and non-opioids (4810mg vs. 2151mg acetaminophen, 1892 vs. 377mg ibuprofen, and 1470mg vs. 393mg naproxen; all p<0.0001). CONCLUSION: Patients require less analgesics (opioids and non-opioids) following robotic surgery in comparison to conventional laparotomy, including the elderly and the obese. The diminished pain medication use is associated with some cost savings.
INTRODUCTION: Minimally invasive surgery (MIS) has been associated with diminished postoperative pain and analgesia requirements. The objective of the current study was to evaluate the use of analgesia in the post-operative period following robotic surgery for endometrial cancer. METHODS: All consecutive patients who underwent robotic surgery for the treatment of endometrial cancer were included in this study. The timing, dose, and type of analgesics administered postoperatively were recorded from patients' electronic medical record. Data was compared to a matched historical cohort of patients who underwent laparotomy before the introduction of the robotic program. RESULTS: Only eight patients (2.4%, 5 during the first 25 cases and 3 following mini-laparotomy) received patient-controlled analgesia (PCA) following robotic surgery. Most patients' pain was alleviated by over-the-counter analgesics (acetaminophen, non-steroidal anti-inflammatories). In comparison to laparotomy, patients who underwent robotic surgery required significantly less opioids (71mg vs. 12mg IV morphine, p<0.0001) and non-opioids (4810mg vs. 2151mg acetaminophen, 1892 vs. 377mg ibuprofen, and 1470mg vs. 393mg naproxen; all p<0.0001). CONCLUSION:Patients require less analgesics (opioids and non-opioids) following robotic surgery in comparison to conventional laparotomy, including the elderly and the obese. The diminished pain medication use is associated with some cost savings.
Authors: Jeremie Abitbol; Beste Kucukyazici; Sonya Brin; Susie Lau; Shannon Salvador; Agnihotram V Ramanakumar; Roy Kessous; Liron Kogan; John D Fletcher; Valerie Pare-Miron; Gilbert Liu; Walter H Gotlieb Journal: J Robot Surg Date: 2022-08-04
Authors: Marieke J Krimphove; Xi Chen; Maya Marchese; David F Friedlander; Adam C Fields; Lina Roa; Daniel Pucheril; Adam S Kibel; Nelya Melnitchouk; Richard D Urman; Luis A Kluth; Prokar Dasgupta; Quoc-Dien Trinh Journal: BMC Surg Date: 2020-10-14 Impact factor: 2.102