Gary Duclos1, Aude Charvet1, Noémie Resseguier2, Delphine Trousse3, Xavier-Benoit D'Journo3, Laurent Zieleskiewicz1, Pascal-Alexandre Thomas3, Marc Leone1. 1. Department of Anaesthesia and Intensive Care, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Hôpital Nord, Marseille, France. 2. Support Unit for Clinical Research and Economic Evaluation, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Hôpital Nord, Marseille, France. 3. Department of Thoracic and Esophageal Surgery, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Hôpital Nord, Marseille, France.
Abstract
BACKGROUND: Robotic assistance is increasingly being used for treatment of early stage of non-small cell lung cancer. Our objectives were to compare the morphine consumption during the postoperative 48 hours after robotic-assisted thoracic surgery and that after video-assisted thoracic surgery as well as compare the patient's haemodynamic and respiratory function during the procedures. METHODS: This observational, prospective study was conducted in a single referral centre for thoracic surgery from January 2016 to March 2017. Patients who were scheduled to undergo surgical lung resection were included. A propensity score based on age, sex, American society of Anesthesiology score was used between groups. Linear regression analyses were used to determine the mean difference in the postoperative morphine consumption. We also compared the haemodynamic and respiratory function during the two procedures. RESULTS: Among the 194 patients included, 105 (54%) and 89 (46%) underwent video and robotic surgery, respectively. Total 75 of each group were matched using the propensity score. The consumption of morphine was 23.0 (16.5-39.0) mg and 33.0 (19.3-46.5) mg (P=0.05) in the video and robotic groups, respectively. Linear regression revealed an average difference β (95% CI) of 6.76 mg (0.32-13.26) (P=0.04) in the morphine consumption after adjusting for the body mass index and local anaesthetic use. Robotic surgery was associated with worse haemodynamic and respiratory function than video surgery. CONCLUSIONS: As compared with video, robotic surgery was associated with increased use of morphine and greater alteration in the haemodynamic and respiratory functions.
BACKGROUND: Robotic assistance is increasingly being used for treatment of early stage of non-small cell lung cancer. Our objectives were to compare the morphine consumption during the postoperative 48 hours after robotic-assisted thoracic surgery and that after video-assisted thoracic surgery as well as compare the patient's haemodynamic and respiratory function during the procedures. METHODS: This observational, prospective study was conducted in a single referral centre for thoracic surgery from January 2016 to March 2017. Patients who were scheduled to undergo surgical lung resection were included. A propensity score based on age, sex, American society of Anesthesiology score was used between groups. Linear regression analyses were used to determine the mean difference in the postoperative morphine consumption. We also compared the haemodynamic and respiratory function during the two procedures. RESULTS: Among the 194 patients included, 105 (54%) and 89 (46%) underwent video and robotic surgery, respectively. Total 75 of each group were matched using the propensity score. The consumption of morphine was 23.0 (16.5-39.0) mg and 33.0 (19.3-46.5) mg (P=0.05) in the video and robotic groups, respectively. Linear regression revealed an average difference β (95% CI) of 6.76 mg (0.32-13.26) (P=0.04) in the morphine consumption after adjusting for the body mass index and local anaesthetic use. Robotic surgery was associated with worse haemodynamic and respiratory function than video surgery. CONCLUSIONS: As compared with video, robotic surgery was associated with increased use of morphine and greater alteration in the haemodynamic and respiratory functions.
Entities:
Keywords:
Robotic-assisted thoracic surgery (RATS); lung resection; morphine consumption; video-assisted thoracic surgery (VATS)
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