Anaesthetic management for robotic-assisted laparoscopic prostatectomy: the first UK national survey of current practice

J Robot Surg. 2021 Jun;15(3):335-341. doi: 10.1007/s11701-020-01105-3. Epub 2020 Jun 24.

Abstract

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.

Keywords: Enhanced recovery; Pain management; Robotic prostatectomy.

MeSH terms

  • Anesthesia / methods*
  • Anesthesia / statistics & numerical data
  • Anesthesia, Intravenous / statistics & numerical data
  • Anesthesia, Spinal / statistics & numerical data
  • Enhanced Recovery After Surgery
  • Heroin
  • Hospitals / statistics & numerical data
  • Humans
  • Laparoscopy / methods*
  • Length of Stay / statistics & numerical data
  • Male
  • Prostatectomy / methods*
  • Robotic Surgical Procedures / methods*
  • Surveys and Questionnaires
  • United Kingdom

Substances

  • Heroin