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Title: Multidimensional comparison of acute postoperative pain and pain management following open and robotic-assisted radical prostatectomy for localised prostate cancer.
Epworth Authors: Khaw, Damien
Hutchinson, Alison
Botti, Mari
Keywords: Acute Postoperative Pain
Pain Management
Analgesic Management
Localised Prostate Cancer
Minimally Invasive Surgery
Patient Experience
Radical Prostatectomy
Retropubic Radical Prostatectomy
Robotic-Assisted Radical Prostatectomy
Opioid Equivalent Analgesics
Surgical Incision Pain
Distinct Profiles of Acute Postoperative Pain
Insufflation of the Peritoneum
Pain Intensity Ratings
Pain Expectation
Postsurgical Pain Treatment Decision-Making
Patient Outcomes After Prostate Surgery Investigators
Cancer Services Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Jun-2017
Citation: Epworth Research Institute Research Week 2017; Poster 19: pp 42
Conference Name: Epworth Research Institute Research Week 2017
Conference Location: Epworth Research Institute, Victoria, Australia
Abstract: BACKGROUND: Rapid advances in surgical approaches to radical prostatectomy (RP) require concurrent investigation of the implications of approach on patient experience. In particular, there is needed a better understanding of the quality and outcomes of postoperative pain management associated with open and minimally invasive techniques. METHODS AND RESULTS: We compared the outcomes of postoperative pain care in the first 24-hours following retropubic radical prostatectomy (RRP) (n = 209) and robotic-assisted prostatectomy (RARP) (n = 193) for localized prostate cancer. Overall, 31.8% of men had experienced a worst pain intensity (µ = 5.8/10, sd = 2.7) that was moderate-to-severe (pain ≥ 4/10) in the previous 24 hours. RARP patients had similar pain intensity to RRP patients however, RARP patients received less opiod equivalent analgesics (µ = 30.8mg, sd = 24.4mg) than RRP patients (µ = 44mg, sd = 30.7mg), (p <.001) and less of their available analgesics overall (23.4% vs. 29.8%), (p< .001). Typical location of pain was also different between groups. RRP was more likely to be associated with the surgical incision pain and RARP with pain consistent with insufflation of the peritoneum (lower abdominal and shoulder tip). DISCUSSION: Analyses identified distinct profiles of acute postoperative pain for RRP and RARP. Relatively high pain intensity ratings and differences in analgesic management between the two surgery types, suggest that the expectation of less pain associated with minimally invasive surgery may influence postsurgical pain treatment decision-making and care. These expectations may undermine the potential advantage of minimally invasive surgery.
Type: Conference Poster
Affiliated Organisations: Deakin University, Geelong. Centre for Quality and Patient Safety Research-Epworth HealthCare Partnership.
Deakin University, Geelong. School of Nursing and Midwifery.
Type of Clinical Study or Trial: Comparative Study
Appears in Collections:Cancer Services
Epworth Prostate Centre
Pain Management
Research Month
UroRenal, Vascular

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