Royal Marsden Hospital, Royal Marsden NHS Foundation Trust, 203 Fulham Road, London, SW3 6JJ, UK.
North Bristol NHS Trust, Bristol, UK.
J Robot Surg. 2021 Jun;15(3):335-341. doi: 10.1007/s11701-020-01105-3. Epub 2020 Jun 24.
Robotic-assisted laparoscopic prostatectomy (RALP) is the most common robotic surgical procedure, but there are little published data to inform anaesthetic practice. We aimed to characterise the range of anaesthetic practice for RALP in the United Kingdom through a national survey. We conducted an online national survey to determine current anaesthetic practice for RALP. The survey was distributed to all NHS hospitals within the UK that perform RALP. Thirty-four (79%) of 43 hospitals responded to the survey. Fourteen (41%) centres routinely provide spinal anaesthesia and 79% of these use diamorphine as their intrathecal opioid of choice. Thirty-one (91%) centres administer intravenous strong opioids intraoperatively, and a wide range of non-opioid analgesic agents are also administered. Five (15%) centres reported that they discharge a minority of patients on the day of surgery. High-volume centres are more likely to have a formalised enhanced recovery after surgery (ERAS) pathway and to provide ambulatory surgery for selected patients. This represents the first UK national survey of anaesthetic practice for RALP. The results of the survey revealed significant variation in anaesthetic practice implying a lack of consensus on best perioperative management.
机器人辅助腹腔镜前列腺切除术（RALP）是最常见的机器人手术，但有关麻醉实践的文献资料很少。我们旨在通过全国性调查来描述英国 RALP 麻醉实践的范围。我们进行了一项在线全国性调查，以确定 RALP 的当前麻醉实践。该调查分发给英国进行 RALP 的所有 NHS 医院。43 家医院中有 34 家（79%）对调查做出了回应。14 家（41%）中心常规提供脊髓麻醉，其中 79%的中心使用吗啡作为首选鞘内阿片类药物。31 家（91%）中心在手术期间给予静脉内强阿片类药物，并且还给予了广泛的非阿片类镇痛药物。5 家（15%）中心报告说，他们有少数患者在手术当天出院。高容量中心更有可能制定正式的术后强化康复（ERAS）方案，并为选定的患者提供门诊手术。这是英国首次对 RALP 麻醉实践进行的全国性调查。调查结果显示，麻醉实践存在显著差异，这意味着在围手术期管理方面缺乏共识。
