Neuraxial anesthesia versus general anesthesia in patients undergoing three-dimensional laparoscopic radical prostatectomy: Preliminary results of a prospective comparative study
Objective: Neuraxial anesthesia (NA) showed to reduce both morbidity and mortality in patients undergoing laparoscopic surgery. We aimed to investigate the use of NA in patients undergoing transperitoneal three-dimensional laparoscopic radical prostatectomy (t-3DLRP) and compare the intraoperative a...
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| Language: | English |
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Elsevier
2023-07-01
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| Series: | Asian Journal of Urology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214388222001114 |
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| author | Stefano Alba Deborah Fimognari Fabio Crocerossa Luigi Ascalone Carmine Pullano Fernando Chiaravalloti Francesco Chiaradia Umberto Carbonara Matteo Ferro Ottavio de Cobelli Vincenzo Pagliarulo Giuseppe Lucarelli Michele Battaglia Rocco Damiano Francesco Cantiello |
| author_facet | Stefano Alba Deborah Fimognari Fabio Crocerossa Luigi Ascalone Carmine Pullano Fernando Chiaravalloti Francesco Chiaradia Umberto Carbonara Matteo Ferro Ottavio de Cobelli Vincenzo Pagliarulo Giuseppe Lucarelli Michele Battaglia Rocco Damiano Francesco Cantiello |
| author_sort | Stefano Alba |
| collection | DOAJ |
| description | Objective: Neuraxial anesthesia (NA) showed to reduce both morbidity and mortality in patients undergoing laparoscopic surgery. We aimed to investigate the use of NA in patients undergoing transperitoneal three-dimensional laparoscopic radical prostatectomy (t-3DLRP) and compare the intraoperative and postoperative outcomes with a control group of patients undergoing t-3DLRP under general anesthesia (GA). Methods: A prospective, double-center, double-surgeon study cohort of 84 consecutive patients undergoing t-3DLRP between June 2019 and June 2021 was analyzed. A study group of 42 patients undergoing t-3DLRP under NA was compared with a control group of 42 patients undergoing t-3DLRP under GA. Results: The two group were similar in all demographic, clinical, and pathological variables. Postoperative blood gas parameters were within physiologic limits in both groups. Muscle relaxation was adequate for surgery during both NA and GA. Median length of stay was 1 day shorter for NA group than GA group (5 days vs. 6 days, p=0.05). t-3DLRP under NA had a statistically lower rate of minor complications (4.8% vs. 19.0%, p=0.03) and less postoperative pain (median numeric rating scale 3 vs. 4, p=0.01) compared to GA. No major complications were observed in both groups. Significantly more patients were willing to undergo a similar intervention under NA than GA (p=0.04). Conclusion: t-3DLRP under NA is a feasible and safe procedure, with less postoperative pain and fewer minor complications than the same procedure under GA. NA allows the maintenance of muscle relaxation and respiratory excursions without interfering with surgery. |
| format | Article |
| id | doaj-art-cf50b093327e470b9b16ec6d1411a01c |
| institution | Kabale University |
| issn | 2214-3882 |
| language | English |
| publishDate | 2023-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Urology |
| spelling | doaj-art-cf50b093327e470b9b16ec6d1411a01c2025-08-20T03:24:48ZengElsevierAsian Journal of Urology2214-38822023-07-0110332933610.1016/j.ajur.2022.04.006Neuraxial anesthesia versus general anesthesia in patients undergoing three-dimensional laparoscopic radical prostatectomy: Preliminary results of a prospective comparative studyStefano Alba0Deborah Fimognari1Fabio Crocerossa2Luigi Ascalone3Carmine Pullano4Fernando Chiaravalloti5Francesco Chiaradia6Umberto Carbonara7Matteo Ferro8Ottavio de Cobelli9Vincenzo Pagliarulo10Giuseppe Lucarelli11Michele Battaglia12Rocco Damiano13Francesco Cantiello14Department of Urology, Romolo Hospital, Rocca di Neto, Kr, ItalyDepartment of Urology, Magna Graecia University of Catanzaro, Catanzaro, ItalyDepartment of Urology, Magna Graecia University of Catanzaro, Catanzaro, ItalyDepartment of Urology, Romolo Hospital, Rocca di Neto, Kr, ItalyDepartment of Anesthesiology, Villa Pia, Roma, ItalyDepartment of Anesthesiology, Romolo Hospital, Rocca di Neto Kr, ItalyDepartment of Urology, Romolo Hospital, Rocca di Neto, Kr, ItalyUniversità degli Studi di Bari Aldo Moro, Department of Urology, Bari, ItalyDivision of Urology, European Institute of Oncology (IEO), IRCCS, Milan, ItalyDivision of Urology, European Institute of Oncology (IEO), IRCCS, Milan, Italy; Department of Oncology and Hematology Oncology, Faculty of Medicine and Surgery, University of Milan, Milan, ItalyDepartment of Urology, Vito Fazzi Hospital, Lecce, ItalyDepartment of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, ItalyDepartment of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, ItalyDepartment of Urology, Magna Graecia University of Catanzaro, Catanzaro, ItalyDepartment of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy; Corresponding author.Objective: Neuraxial anesthesia (NA) showed to reduce both morbidity and mortality in patients undergoing laparoscopic surgery. We aimed to investigate the use of NA in patients undergoing transperitoneal three-dimensional laparoscopic radical prostatectomy (t-3DLRP) and compare the intraoperative and postoperative outcomes with a control group of patients undergoing t-3DLRP under general anesthesia (GA). Methods: A prospective, double-center, double-surgeon study cohort of 84 consecutive patients undergoing t-3DLRP between June 2019 and June 2021 was analyzed. A study group of 42 patients undergoing t-3DLRP under NA was compared with a control group of 42 patients undergoing t-3DLRP under GA. Results: The two group were similar in all demographic, clinical, and pathological variables. Postoperative blood gas parameters were within physiologic limits in both groups. Muscle relaxation was adequate for surgery during both NA and GA. Median length of stay was 1 day shorter for NA group than GA group (5 days vs. 6 days, p=0.05). t-3DLRP under NA had a statistically lower rate of minor complications (4.8% vs. 19.0%, p=0.03) and less postoperative pain (median numeric rating scale 3 vs. 4, p=0.01) compared to GA. No major complications were observed in both groups. Significantly more patients were willing to undergo a similar intervention under NA than GA (p=0.04). Conclusion: t-3DLRP under NA is a feasible and safe procedure, with less postoperative pain and fewer minor complications than the same procedure under GA. NA allows the maintenance of muscle relaxation and respiratory excursions without interfering with surgery.http://www.sciencedirect.com/science/article/pii/S2214388222001114LaparoscopyProstate cancerRadical prostatectomyPostoperative complicationsNeuraxial anesthesiaGeneral anesthesia |
| spellingShingle | Stefano Alba Deborah Fimognari Fabio Crocerossa Luigi Ascalone Carmine Pullano Fernando Chiaravalloti Francesco Chiaradia Umberto Carbonara Matteo Ferro Ottavio de Cobelli Vincenzo Pagliarulo Giuseppe Lucarelli Michele Battaglia Rocco Damiano Francesco Cantiello Neuraxial anesthesia versus general anesthesia in patients undergoing three-dimensional laparoscopic radical prostatectomy: Preliminary results of a prospective comparative study Asian Journal of Urology Laparoscopy Prostate cancer Radical prostatectomy Postoperative complications Neuraxial anesthesia General anesthesia |
| title | Neuraxial anesthesia versus general anesthesia in patients undergoing three-dimensional laparoscopic radical prostatectomy: Preliminary results of a prospective comparative study |
| title_full | Neuraxial anesthesia versus general anesthesia in patients undergoing three-dimensional laparoscopic radical prostatectomy: Preliminary results of a prospective comparative study |
| title_fullStr | Neuraxial anesthesia versus general anesthesia in patients undergoing three-dimensional laparoscopic radical prostatectomy: Preliminary results of a prospective comparative study |
| title_full_unstemmed | Neuraxial anesthesia versus general anesthesia in patients undergoing three-dimensional laparoscopic radical prostatectomy: Preliminary results of a prospective comparative study |
| title_short | Neuraxial anesthesia versus general anesthesia in patients undergoing three-dimensional laparoscopic radical prostatectomy: Preliminary results of a prospective comparative study |
| title_sort | neuraxial anesthesia versus general anesthesia in patients undergoing three dimensional laparoscopic radical prostatectomy preliminary results of a prospective comparative study |
| topic | Laparoscopy Prostate cancer Radical prostatectomy Postoperative complications Neuraxial anesthesia General anesthesia |
| url | http://www.sciencedirect.com/science/article/pii/S2214388222001114 |
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