The authors prospectively included 52 consecutive patients undergoing RARC at a single institution between November 2016 – December 2017. For comparison, they retrospectively evaluated 41 consecutive patients between October 2016 – October 2017 who received a standard pain control regimen.
They found a shorter time to a regular diet, median 4 days (IQR 3-5) versus 5 days (IQR 4-8), p=0.002 and shorter length of stay median 5 days (IQR 4-7) versus 7 days (IQR 6-11), p<0.001. They found no significant differences in rate of ileus, readmission or costs. Notably, these patients are not on a true ERAS protocol (as is demonstrated in their slower rate of diet advancement), but their care incorporates certain aspects of it including some of the pain regimen components—e.g. acetaminophen, gabapentin, celecoxib.
In conclusion, a non-narcotic perioperative pain management protocol in patients undergoing RARC is feasible and associated with a shorter time to regular diet and shorter length of stay. It is not significantly associated with lower late of ileus, readmission or costs.
Presented by: Kyrollis Attalla, MD, Urological Surgery Resident, Icahn School of Medicine at Mount Sinai
Written by: Selma Masic, MD, Urologic Oncology Fellow (SUO), Fox Chase Cancer Center, @selmasic at the American Urological Association's 2019 Annual Meeting (AUA 2019), May 3 – 6, 2019 in Chicago, Illinois