Department of Surgery, Larner College of Medicine at the University of Vermont, Burlington, VT.
Department of Surgery, Larner College of Medicine at the University of Vermont, Burlington, VT; Department of Surgery, University of Vermont Medical Center, Burlington, VT.
Urology. 2023 Mar;173:75-80. doi: 10.1016/j.urology.2022.10.022. Epub 2022 Nov 17.
To evaluate patient reported measures in patients undergoing endourologic procedures and robotic assisted radical prostatectomy (RARP) to demonstrate the efficacy of non-opioid postoperative pain management strategies.
A prospective cohort study performed at an academic medical center included a patient telephone questionnaire and chart review. Opioid prescriptions, opioid use, and patient reported outcomes were recorded. Bivariate analyses were used to compare patients who did and did not use opioids in the RARP cohort while overall trends were reported for the endourologic procedures.
Of the 68 patients undergoing endoscopic intervention, 14 (21%) were prescribed an opioid and 6 (9%) reported any opioid use. 58 (85%) reported their pain was very well or well controlled while 9 reported their pain was poorly controlled. 59 (87%) were satisfied or very satisfied with their pain control. Fifty-three (93%) of the 57 patients undergoing RARP received an opioid prescription and only 23 reported any opioid use. All but 1 patient reported that their pain was well or very well controlled and almost all (54) of the patients were satisfied with their level of pain control. 36 (63%) reported their pain was less than expected while only 7 (12%) reported it was more than expected.
Most patients undergoing endourologic procedures do not use postoperative opioids and report favorable outcomes regarding their pain control. Similarly, after RARP, most patients do not use opioids even when they are prescribed and are satisfied with their pain control.
评估接受腔内泌尿外科手术和机器人辅助根治性前列腺切除术（RARP）的患者的报告结果测量指标，以证明非阿片类术后疼痛管理策略的疗效。
一项在学术医疗中心进行的前瞻性队列研究包括患者电话问卷调查和病历回顾。记录阿片类药物处方、阿片类药物使用情况和患者报告的结果。采用双变量分析比较 RARP 队列中使用和未使用阿片类药物的患者，同时报告腔内泌尿外科手术的总体趋势。
在接受内镜介入治疗的 68 例患者中，14 例（21%）开了阿片类药物处方，6 例（9%）报告使用了阿片类药物。58 例（85%）报告疼痛控制得非常好或很好，9 例报告疼痛控制得很差。59 例（87%）对疼痛控制感到满意或非常满意。在接受 RARP 的 57 例患者中，53 例（93%）开了阿片类药物处方，只有 23 例报告使用了阿片类药物。除 1 例患者外，所有患者均报告疼痛得到很好或非常好的控制，几乎所有（54 例）患者对疼痛控制水平感到满意。36 例（63%）报告疼痛比预期的轻，只有 7 例（12%）报告疼痛比预期的重。
大多数接受腔内泌尿外科手术的患者术后不使用阿片类药物，且对疼痛控制的效果评价良好。同样，在接受 RARP 后，即使开了阿片类药物处方，大多数患者也不使用阿片类药物，且对疼痛控制感到满意。
