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COMBINATION OF INTRAVENOUS AND SPINAL ANALGESIA PLUS TAP BLOCK GIVES A BETTER CONTROL OF POSTOPERATIVE PAIN THAN MULTIMODAL INTRAVENOUS ANALGESIA AFTER RARP
Author(s): ,
Radev , V.*
Affiliations:
Medical University of Pleven, Clinic of Anesthesiology and Intensive care- University Hospital, Pleven, Bulgaria
,
Bogdanov , S.
Affiliations:
Medical University of Pleven, Clinic of Anesthesiology and Intensive care- University Hospital, Pleven, Bulgaria
,
Radev , R.
Affiliations:
Medical University of Pleven, Clinic of Anesthesiology and Intensive care- University Hospital, Pleven, Bulgaria
,
Kolev , N.
Affiliations:
Medical University of Pleven, Clinic of Urology- University Hospital, Pleven, Bulgaria
,
Arabadzhieva , D.
Affiliations:
University Hospital Ruse, Department of Anesthesiology and Intensive care, Ruse, Bulgaria
Tonchev , P.
Affiliations:
Medical University of Pleven, Clinic of Plastic and reconstructive surgery- University Hospital, Pleven, Bulgaria
ESRA Academy. Radev V. Sep 13, 2017; 190996
Topic: TUR Bladder / Prostate
Dr. Vladimir Radev
Dr. Vladimir Radev

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Abstract
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Background and Aims:

The prostate cancer (PC) is the most common cancer for men. Robotic assisted radical prostatectomy (RARP) is a new technology, improving survival after surgical treatment. Optimal intra and postoperative pain management is required after RARP. 

Methods:

Forty-six patients with RARP for PC were randomized in prospective study comparing two groups with different approach for intra and postoperative pain management. First group were patients with multimodal intravenous analgesia and second group: with spinal analgesia plus TAP block. Visual analogue pain score (VAS) at rest and during movement at 6, 12 and 24 hours after surgery, was used to study the pain and to optimize the morphine needs in both groups. Descriptive, central tendency statistics of VAS points and opioid dosages and Student t tests were used to compare the groups.

Results:

Pain at rest at 6 and 24 hours after surgery shows significant difference between the two groups (6h: 3.08±0.3 mm vs 2.33±0.25 mm, P <0,05 ; 12h: 1,0±0.1 vs  0,98±0.10 mm, P <0,05). We didn’t find the difference between VAS at rest at 12 hours in two groups. We noticed significant difference between two groups in: VAS during movement at 6,12 and 24 hours after surgery; in the morphine consumption and in intraoperative use of opioids (520μg±40 μg fentanyl vs 270 μg±55fentanyl P <0,05).

Conclusions:

The use of multimodal intravenous nonopioid analgesia is insufficient to reach a good control of pain but in combination with others techniques of locoregional analgesia we could found a good level of pain control.

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