Pre-emptive pain regimen decreased opioid usage in patients undergoing robotic prostatectomy

June 24, 2010

Reporting in the journal Urology, researchers at Thomas Jefferson University have found that a pre-emptive multimodal pain regimen that included pregabalin (Lyrica) decreased the use of opioid analgesics in patients undergoing robotic-assisted laparoscopic radical prostatectomy.

Opioid usage, which involves narcotic pain medications, was significantly less in patients who received the multimodal regimen compared to patients who received a standard postoperative analgesic regimen. The mean opioid dose, which was measured in "total morphine equivalent dose," was 75.3 mg for patients who received the standard regimen, versus 49.1 mg for patients who received the multimodal regimen.

"This is the first demonstration of the effectiveness of a pre-emptive pain management protocol using pregabalin in urologic surgery," said Edouard J. Trabulsi, M.D., associate professor of Urology at Jefferson Medical College of Thomas Jefferson University. "We think this study paves the way for new pain management protocols. Though a larger prospective study is necessary to accurately characterize the benefit of reducing opioids, it could have significant implications not only for robotic , but also other laparoscopic procedures and more painful surgeries."

Dr. Trabulsi and colleagues from the Urology and Anesthesiology departments at Jefferson conducted a retrospective study of 60 patients, all undergoing robotic prostatectomy. Thirty of the patients received the multimodal pre-operative treatment and 30 previous patients received only the standard postoperative analgesic regimen.

The pre-operative treatment included pregabalin, acetaminophen and celecoxib given orally, two hours before the procedure, and continued postoperatively in combination with intravenous ketorolac. The standard postoperative analgesic regimen included intravenous ketorolac, without pregabalin or celecoxib. All patients received as needed.

Importantly, in addition to the reduced opioid usage, patients who received the pre-operative regimen did not report any additional side effects.

Although laparoscopic surgical techniques typically are associated with a reduction of postoperative pain, patients still require opioid analgesia. The side effects of opioid often hinder the benefits of laparoscopic surgery. Side effects include nausea, vomiting, a delay in the return of bowel function, ileus, respiratory depression, pruritus, urinary retention and altered sensorium.

Related Stories

Recommended for you

Lung cancer triggers pulmonary hypertension

November 17, 2017
Shortness of breath and respiratory distress often increase the suffering of advanced-stage lung cancer patients. These symptoms can be triggered by pulmonary hypertension, as scientists at the Max Planck Institute for Heart ...

Researchers discover an Achilles heel in a lethal leukemia

November 16, 2017
Researchers have discovered how a linkage between two proteins in acute myeloid leukemia enables cancer cells to resist chemotherapy and showed that disrupting the linkage could render the cells vulnerable to treatment. St. ...

Computer program finds new uses for old drugs

November 16, 2017
Researchers at the Case Comprehensive Cancer Center at Case Western Reserve University School of Medicine have developed a computer program to find new indications for old drugs. The computer program, called DrugPredict, ...

Pharmacoscopy improves therapy for relapsed blood cancer in a first clinical trial

November 16, 2017
Researchers at CeMM and the Medical University of Vienna presented a preliminary report in The Lancet Hematology on the clinical impact of an integrated ex vivo approach called pharmacoscopy. The procedures measure single-cell ...

Wider sampling of tumor tissues may guide drug choice, improve outcomes

November 15, 2017
A new study focused on describing genetic variations within a primary tumor, differences between the primary and a metastatic branch of that tumor, and additional diversity found in tumor DNA in the blood stream could help ...

A new strategy for prevention of liver cancer development

November 14, 2017
Primary liver cancer is now the second leading cause of cancer-related death worldwide, and its incidences and mortality are increasing rapidly in the United Stated. In late stages of the malignancy, there are no effective ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.