학술논문
The effect of anesthetic techniques on postoperative outcomes of open prostatectomy in the era of enhanced recovery after surgery
ORIGINAL ARTICLE
ORIGINAL ARTICLE
Document Type
Academic Journal
Author
Source
Gulhane Medical Journal. December 2021, Vol. 63 Issue 4, p287, 5 p.
Subject
Language
English
ISSN
1302-0471
Abstract
Introduction As men age, benign prostate hyperplasia (BPH) becomes a common disease with a prevalence up to 60% until 9th decade (1). Although transurethral techniques such as resection, vaporization, and [...]
Aims: As the enhanced recovery after surgery (ERAS) concept gains popularity in the surgical practice, the anesthetic technique has a more important effect on the postoperative course, especially in aged population. The aim of this study was to compare general anesthesia (GA) with spinal anesthesia (SA) regarding the perioperative outcomes with respect to the ERAS protocols in open prostatectomy (OP) for benign prostate hyperplasia. Methods: This retrospective study included patients between 40 and 90 years of age who underwent elective OP between 2014 and 2020. Data were collected from hospital's database, patient files, and anesthesia charts. The exclusion criteria were malignancy, lost to follow-up, and missing data. Primary outcome measures were perioperative variables. Secondary outcome measures were factors influencing hospital discharge time. Results: Of 105 patients (age, mean[+ or -]SD: 68.3[+ or -]5.7 years) included in the study, 61 patients were administered in GA (group GA) and 44 in SA (group SA). As the primary outcome measures, when compared with group SA, deliberate hypotensive anesthesia was required in more patients [26 (42.6%) vs. 15 (34.1%); p=0.027] and transfusion rate was higher (6.5% vs. 4.5%; p=0.044) in group GA. Mean visual analogue scale score (3.6[+ or -]1.1 vs. 2.8[+ or -]0.4; p=0.040) and opioid consumption (32.8[+ or -]4.4 vs. 26.3[+ or -]4.9 mg; p=0.088) were higher, and time to first rescue analgesic use was also shorter (1.1[+ or -]0.9 vs. 4.7[+ or -]1.3 hours; p=0.011) in group GA when compared with group SA. Conclusions: This study showed that SA was superior to GA in maintaining hemodynamic stability, reducing blood loss, complications, postoperative analgesia requirement, and time to discharge, which are the main goals of ERAS protocols. Keywords: Prostatectomy, general anesthesia, spinal anesthesia, ERAS
Aims: As the enhanced recovery after surgery (ERAS) concept gains popularity in the surgical practice, the anesthetic technique has a more important effect on the postoperative course, especially in aged population. The aim of this study was to compare general anesthesia (GA) with spinal anesthesia (SA) regarding the perioperative outcomes with respect to the ERAS protocols in open prostatectomy (OP) for benign prostate hyperplasia. Methods: This retrospective study included patients between 40 and 90 years of age who underwent elective OP between 2014 and 2020. Data were collected from hospital's database, patient files, and anesthesia charts. The exclusion criteria were malignancy, lost to follow-up, and missing data. Primary outcome measures were perioperative variables. Secondary outcome measures were factors influencing hospital discharge time. Results: Of 105 patients (age, mean[+ or -]SD: 68.3[+ or -]5.7 years) included in the study, 61 patients were administered in GA (group GA) and 44 in SA (group SA). As the primary outcome measures, when compared with group SA, deliberate hypotensive anesthesia was required in more patients [26 (42.6%) vs. 15 (34.1%); p=0.027] and transfusion rate was higher (6.5% vs. 4.5%; p=0.044) in group GA. Mean visual analogue scale score (3.6[+ or -]1.1 vs. 2.8[+ or -]0.4; p=0.040) and opioid consumption (32.8[+ or -]4.4 vs. 26.3[+ or -]4.9 mg; p=0.088) were higher, and time to first rescue analgesic use was also shorter (1.1[+ or -]0.9 vs. 4.7[+ or -]1.3 hours; p=0.011) in group GA when compared with group SA. Conclusions: This study showed that SA was superior to GA in maintaining hemodynamic stability, reducing blood loss, complications, postoperative analgesia requirement, and time to discharge, which are the main goals of ERAS protocols. Keywords: Prostatectomy, general anesthesia, spinal anesthesia, ERAS