Schnabel Timon Marvin, Fetz Katharina, Baagil Hanaa, Kutun Kim, Eisenberger Claus, Gerbershagen Mark Ulrich
Department of Anaesthesiology, Witten/Herdecke University, Cologne-Holweide Hospital, Neufelder Str. 32, 51067 Cologne, Germany.
Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Ostmerheimerstraße 200, 51109 Cologne, Germany.
Medicina (Kaunas). 2025 Apr 15;61(4):732. doi: 10.3390/medicina61040732.
Prostatectomy is a common surgical procedure for prostate cancer, the most frequently diagnosed cancer in the male population. The choice of anaesthetic technique has a significant impact on postoperative pain management. The changes in recommendations between 2015 and 2021 prompted this study to evaluate the impact of intrathecal morphine administration in combination with general anaesthesia compared to general anaesthesia alone on postoperative analgesic consumption and the associated side effects. A single-centre retrospective cohort study was conducted, analysing data from 202 patients who underwent a prostatectomy between 2015 and 2021. Patients were divided into two groups: 147 patients received intrathecal morphine combined with general anaesthesia, while 49 patients received general anaesthesia alone. Key postoperative parameters, including numerical rating scale (NRS) scores, analgesic consumption, and side effects (e.g., nausea, pruritus, hypotension, and respiratory depression) were evaluated. Statistical analyses were performed using Mann-Whitney U-tests and multiple regression models. The group receiving intrathecal morphine showed a significant decrease in NRS pain scores at rest and during movement in the recovery room ( < 0.001). The need for postoperative analgesics, especially opioids such as piritramide, was reduced in this group. No significant increase in serious side effects such as respiratory depression was observed. The present study investigates the potential of intrathecal morphine combined with general anaesthesia as a promising approach to improve pain management in prostatectomy patients. By reducing pain intensity, this method shows significant clinical benefits. In addition, the absence of a significant increase in serious adverse events reinforces the safety of this approach. However, further studies are warranted to assess the long-term outcomes and explore optimal dosing strategies. The reintroduction of this anaesthetic technique has great potential to improve patient recovery and satisfaction following major surgery.
前列腺切除术是治疗前列腺癌的常见外科手术，前列腺癌是男性群体中最常被诊断出的癌症。麻醉技术的选择对术后疼痛管理有重大影响。2015年至2021年间建议的变化促使本研究评估与单纯全身麻醉相比，鞘内注射吗啡联合全身麻醉对术后镇痛药物消耗及相关副作用的影响。进行了一项单中心回顾性队列研究，分析了2015年至2021年间接受前列腺切除术的202例患者的数据。患者分为两组：147例患者接受鞘内注射吗啡联合全身麻醉，而49例患者仅接受全身麻醉。评估了关键的术后参数，包括数字评定量表（NRS）评分、镇痛药物消耗和副作用（如恶心、瘙痒、低血压和呼吸抑制）。使用曼-惠特尼U检验和多元回归模型进行统计分析。接受鞘内注射吗啡的组在恢复室静息和活动时的NRS疼痛评分显著降低（<0.001）。该组术后对镇痛药物尤其是如匹米诺定等阿片类药物的需求减少。未观察到呼吸抑制等严重副作用有显著增加。本研究调查了鞘内注射吗啡联合全身麻醉作为改善前列腺切除患者疼痛管理的一种有前景方法的潜力。通过降低疼痛强度，该方法显示出显著的临床益处。此外，严重不良事件无显著增加强化了该方法的安全性。然而，需要进一步研究来评估长期结果并探索最佳给药策略。重新引入这种麻醉技术对于改善大手术后患者的恢复和满意度具有巨大潜力。
