The effects of method of anaesthesia on the safety and effectiveness of Radical Retropubic Prostatectomy
Objective: The aim of this study is to determine if patients undergoing radical retropubic prostatectomy with localized prostate cancer under combined (epidural-spinal) anaesthesia have any benefit over patients undergoing the procedure under general anaesthesia. Material and Methods: Patients with...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
PAGEPress Publications
2022-12-01
|
| Series: | Archivio Italiano di Urologia e Andrologia |
| Subjects: | |
| Online Access: | https://www.pagepressjournals.org/index.php/aiua/article/view/10933 |
| _version_ | 1828085640792637440 |
|---|---|
| author | Konstantinos Pikramenos Maria Zachou Eleftheria Apostolatou Dimitrios Papadopoulos Maria Mitsogianni Athanasios Papatsoris Ioannis Varkarakis Iraklis Mitsogiannis |
| author_facet | Konstantinos Pikramenos Maria Zachou Eleftheria Apostolatou Dimitrios Papadopoulos Maria Mitsogianni Athanasios Papatsoris Ioannis Varkarakis Iraklis Mitsogiannis |
| author_sort | Konstantinos Pikramenos |
| collection | DOAJ |
| description |
Objective: The aim of this study is to determine if patients undergoing radical retropubic prostatectomy with localized prostate cancer under combined (epidural-spinal) anaesthesia have any benefit over patients undergoing the procedure under general anaesthesia.
Material and Methods: Patients with clinically localised prostate cancer, scheduled for radical retropubic prostatectomy, were allocated to undergo the operation under either general anaesthesia (GA) or under combined (epidural-spinal) (CESA) anaesthesia. Several parameters were recorded both preoperatively (medical history, biometric data, PSA, biopsy Gleason score) and postoperatively (blood pressure, heart rate, haemoglobin levels, operation time and total hospital stay). In addition, mean arterial pressure, change in heart rate, total blood loss, blood transfusions, SAS score, intravenous fluid administration and operation time were also noted down intraoperatively. Patient pain levels and total satisfaction were evaluated using appropriate questionnaires. At the 12-month follow-up, biochemical recurrence using PSA levels and urinary continence status were evaluated.
Results: A total of 60 patients were included (30 in each group). Intraoperatively, mean MAP and heart rate change was higher in the GA group (MAP+7,46, HR+27) and mean SAS was higher in the CESA group (+0.93). The time needed for patients’ recovery was faster (-3.5 min) and hospitalization was shorter for patients in the CESA group (-0.6 days). Intraoperative blood loss, time for induction and duration of operation were not significantly different. Mean postoperative drop of haemoglobin was greater in the GA group (+0.56) while blood transfusions, VAS pain scores and amount of intravenous fluids did not differ significantly between the two groups. No complications were reported. Patient satisfaction and urinary continence were comparable between the groups and there were no cases of biochemical recurrence.
Conclusions: Radical retropubic prostatectomy can safely be performed under combined (spinal epidural anaesthesia, with possible benefits of lower blood loss, less post-operative complications and earlier discharge. Both procedures have equal oncological and functional outcomes at the 12-month follow-up.
|
| first_indexed | 2024-04-11T04:42:39Z |
| format | Article |
| id | doaj.art-bca8d779766c40c8976600f06aece52c |
| institution | Directory Open Access Journal |
| issn | 1124-3562 2282-4197 |
| language | English |
| last_indexed | 2024-04-11T04:42:39Z |
| publishDate | 2022-12-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Archivio Italiano di Urologia e Andrologia |
| spelling | doaj.art-bca8d779766c40c8976600f06aece52c2022-12-27T22:38:33ZengPAGEPress PublicationsArchivio Italiano di Urologia e Andrologia1124-35622282-41972022-12-0194410.4081/aiua.2022.4.396The effects of method of anaesthesia on the safety and effectiveness of Radical Retropubic ProstatectomyKonstantinos Pikramenos0Maria Zachou1Eleftheria Apostolatou2Dimitrios Papadopoulos3Maria Mitsogianni4Athanasios Papatsoris5Ioannis Varkarakis6Iraklis Mitsogiannis72nd Urology Department, Sismanoglio Hospital, National and Kapodistrian University of AthensGastroenterology Department, Sismanoglio Hospital, Athens2nd Urology Department, Sismanoglio Hospital, National and Kapodistrian University of AthensAnaesthesiology Department, Evgenidio Hospital, National and Kapodistrian University of Athens4th Department of Medical Oncology, Hygeia Hospital, Athens2nd Urology Department, Sismanoglio Hospital, National and Kapodistrian University of Athens2nd Urology Department, Sismanoglio Hospital, National and Kapodistrian University of Athens2nd Urology Department, Sismanoglio Hospital, National and Kapodistrian University of Athens Objective: The aim of this study is to determine if patients undergoing radical retropubic prostatectomy with localized prostate cancer under combined (epidural-spinal) anaesthesia have any benefit over patients undergoing the procedure under general anaesthesia. Material and Methods: Patients with clinically localised prostate cancer, scheduled for radical retropubic prostatectomy, were allocated to undergo the operation under either general anaesthesia (GA) or under combined (epidural-spinal) (CESA) anaesthesia. Several parameters were recorded both preoperatively (medical history, biometric data, PSA, biopsy Gleason score) and postoperatively (blood pressure, heart rate, haemoglobin levels, operation time and total hospital stay). In addition, mean arterial pressure, change in heart rate, total blood loss, blood transfusions, SAS score, intravenous fluid administration and operation time were also noted down intraoperatively. Patient pain levels and total satisfaction were evaluated using appropriate questionnaires. At the 12-month follow-up, biochemical recurrence using PSA levels and urinary continence status were evaluated. Results: A total of 60 patients were included (30 in each group). Intraoperatively, mean MAP and heart rate change was higher in the GA group (MAP+7,46, HR+27) and mean SAS was higher in the CESA group (+0.93). The time needed for patients’ recovery was faster (-3.5 min) and hospitalization was shorter for patients in the CESA group (-0.6 days). Intraoperative blood loss, time for induction and duration of operation were not significantly different. Mean postoperative drop of haemoglobin was greater in the GA group (+0.56) while blood transfusions, VAS pain scores and amount of intravenous fluids did not differ significantly between the two groups. No complications were reported. Patient satisfaction and urinary continence were comparable between the groups and there were no cases of biochemical recurrence. Conclusions: Radical retropubic prostatectomy can safely be performed under combined (spinal epidural anaesthesia, with possible benefits of lower blood loss, less post-operative complications and earlier discharge. Both procedures have equal oncological and functional outcomes at the 12-month follow-up. https://www.pagepressjournals.org/index.php/aiua/article/view/10933Prostatic neoplasmRadical prostatectomyComplicationsCombined anaesthesia |
| spellingShingle | Konstantinos Pikramenos Maria Zachou Eleftheria Apostolatou Dimitrios Papadopoulos Maria Mitsogianni Athanasios Papatsoris Ioannis Varkarakis Iraklis Mitsogiannis The effects of method of anaesthesia on the safety and effectiveness of Radical Retropubic Prostatectomy Archivio Italiano di Urologia e Andrologia Prostatic neoplasm Radical prostatectomy Complications Combined anaesthesia |
| title | The effects of method of anaesthesia on the safety and effectiveness of Radical Retropubic Prostatectomy |
| title_full | The effects of method of anaesthesia on the safety and effectiveness of Radical Retropubic Prostatectomy |
| title_fullStr | The effects of method of anaesthesia on the safety and effectiveness of Radical Retropubic Prostatectomy |
| title_full_unstemmed | The effects of method of anaesthesia on the safety and effectiveness of Radical Retropubic Prostatectomy |
| title_short | The effects of method of anaesthesia on the safety and effectiveness of Radical Retropubic Prostatectomy |
| title_sort | effects of method of anaesthesia on the safety and effectiveness of radical retropubic prostatectomy |
| topic | Prostatic neoplasm Radical prostatectomy Complications Combined anaesthesia |
| url | https://www.pagepressjournals.org/index.php/aiua/article/view/10933 |
| work_keys_str_mv | AT konstantinospikramenos theeffectsofmethodofanaesthesiaonthesafetyandeffectivenessofradicalretropubicprostatectomy AT mariazachou theeffectsofmethodofanaesthesiaonthesafetyandeffectivenessofradicalretropubicprostatectomy AT eleftheriaapostolatou theeffectsofmethodofanaesthesiaonthesafetyandeffectivenessofradicalretropubicprostatectomy AT dimitriospapadopoulos theeffectsofmethodofanaesthesiaonthesafetyandeffectivenessofradicalretropubicprostatectomy AT mariamitsogianni theeffectsofmethodofanaesthesiaonthesafetyandeffectivenessofradicalretropubicprostatectomy AT athanasiospapatsoris theeffectsofmethodofanaesthesiaonthesafetyandeffectivenessofradicalretropubicprostatectomy AT ioannisvarkarakis theeffectsofmethodofanaesthesiaonthesafetyandeffectivenessofradicalretropubicprostatectomy AT iraklismitsogiannis theeffectsofmethodofanaesthesiaonthesafetyandeffectivenessofradicalretropubicprostatectomy AT konstantinospikramenos effectsofmethodofanaesthesiaonthesafetyandeffectivenessofradicalretropubicprostatectomy AT mariazachou effectsofmethodofanaesthesiaonthesafetyandeffectivenessofradicalretropubicprostatectomy AT eleftheriaapostolatou effectsofmethodofanaesthesiaonthesafetyandeffectivenessofradicalretropubicprostatectomy AT dimitriospapadopoulos effectsofmethodofanaesthesiaonthesafetyandeffectivenessofradicalretropubicprostatectomy AT mariamitsogianni effectsofmethodofanaesthesiaonthesafetyandeffectivenessofradicalretropubicprostatectomy AT athanasiospapatsoris effectsofmethodofanaesthesiaonthesafetyandeffectivenessofradicalretropubicprostatectomy AT ioannisvarkarakis effectsofmethodofanaesthesiaonthesafetyandeffectivenessofradicalretropubicprostatectomy AT iraklismitsogiannis effectsofmethodofanaesthesiaonthesafetyandeffectivenessofradicalretropubicprostatectomy |