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Neuraxial anesthesia versus general anesthesia in patients undergoing three-dimensional laparoscopic radical prostatectomy:Preliminary results of a prospective comparative study

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Asian Journal of Urology 2023年第3期10卷 329-336页

作者： Stefano Alba Deborah Fimognari Fabio Croceross 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 Department of Urology Romolo HospitalRocca di NetoKrItaly Department of Urology Magna Graecia University of CatanzaroCatanzaroItaly Department of Anesthesiology Villa PiaRomaItaly Department of Anesthesiology Romolo HospitalRocca di Neto KrItaly Universita degli Studi di Bari Aldo Moro Department of UrologyBariItaly Division of Urology European Institute of Oncology(IEO)IRCCSMilanItaly Department of Oncology and Hematology Oncology Faculty of Medicine and SurgeryUniversity of MilanMilanItaly Department of Urology Vito Fazzi HospitalLecceItaly Department of Emergency and Organ Transplantation-Urology Andrology and Kidney Transplantation UnitUniversity of BariBariItaly

Objective:Neuraxial anesthesia(NA)showed to reduce both morbidity and mortality in patients undergoing laparoscopic *** 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 ***:The two group were similar in all demographic,clinical,and pathological *** blood gas parameters were within physiologic limits in both *** relaxation was adequate for surgery during both NA and *** 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 *** major complications were observed in both *** 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 *** allows the maintenance of muscle relaxation and respiratory excursions without interfering with surgery.

关键词： Laparoscopy Prostate cancer Radical prostatectomy Postoperative complications Neuraxial anesthesia General anesthesia

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