Background and Purpose:This study evaluates the safety and efficacy of intravesical ropivacaine as part of a mulitimodal approach to the provision of analgesia following robot assisted radical prostatectomy (RARP).
Patients and Methods:In this double blind, placebo controlled trial, 40 patients scheduled to undergo RARP for treatment of localized prostate cancer by a single surgeon (SP) were randomized 1:1 to receive either alkalinized intravesical ropivacaine or placebo (0.9% sodium chloride) at the completion of the vesico-urethral anastomosis. A standardized general anesthetic was administered in each case. The primary outcome was a reduction in post-operative pain as assessed by a visual analogue scale (VAS). The need for alternate analgesic agents was recorded. Adverse events related to the administration of intravesical ropivacaine were documented prospectively.
Results:No serious adverse events related to the administration of intravesical ropivacaine were identified. In the ropivacaine group, there was a significant reduction in the cumulative required dose of ketoralac relative to placebo at 6 hours post-operatively. There was no statistically significant difference between the groups with regard to pain scores or narcotic use at any time point.
Conclusions: Intravesical administration of ropivacaine may be used safely in the context of RARP and is associated with a significant, albeit modest reduction in the need for supplementary analgesic agents, but did not result in a decrease in post-operative pain scores.
Written by:
Fuller A, Vanderhaeghe L, Nott L, Martin PR, Pautler SE. Are you the author?
University of Western Ontario, Div. of Urology, 268 Grosvenor St, London, Ontario, Canada, N6A 4V2.
Reference: J Endourol. 2012 Sep 11. Epub ahead of print.
doi: 10.1089/end.2012.0191
PubMed Abstract
PMID: 22967208
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