Analysis of postoperative pain in robotic versus traditional laparoscopic hysterectomy.

Autor: Betcher RE; Physicians and Surgeons Clinic, Obstetrics and Gynecology, Baptist Memorial Hospital-Golden Triangle, 225 Baptist Blvd., Columbus, MS, 39705, USA. rebetcher@gmail.com.; Physicians and Surgeons Clinic, Obstetrics and Gynecology, Gilmore Memorial Regional Medical Center, 900 Earl Frye Blvd, Amory, MS, 38821, USA. rebetcher@gmail.com., Chaney JP; Physicians and Surgeons Clinic, Obstetrics and Gynecology, Baptist Memorial Hospital-Golden Triangle, 225 Baptist Blvd., Columbus, MS, 39705, USA.; Physicians and Surgeons Clinic, Obstetrics and Gynecology, Gilmore Memorial Regional Medical Center, 900 Earl Frye Blvd, Amory, MS, 38821, USA., Lacy PR; Physicians and Surgeons Clinic, Obstetrics and Gynecology, Baptist Memorial Hospital-Golden Triangle, 225 Baptist Blvd., Columbus, MS, 39705, USA.; Physicians and Surgeons Clinic, Obstetrics and Gynecology, Gilmore Memorial Regional Medical Center, 900 Earl Frye Blvd, Amory, MS, 38821, USA., Otey SK; Physicians and Surgeons Clinic, Obstetrics and Gynecology, Baptist Memorial Hospital-Golden Triangle, 225 Baptist Blvd., Columbus, MS, 39705, USA.; Physicians and Surgeons Clinic, Obstetrics and Gynecology, Gilmore Memorial Regional Medical Center, 900 Earl Frye Blvd, Amory, MS, 38821, USA., Wood DJ; Physicians and Surgeons Clinic, Obstetrics and Gynecology, Baptist Memorial Hospital-Golden Triangle, 225 Baptist Blvd., Columbus, MS, 39705, USA.; Physicians and Surgeons Clinic, Obstetrics and Gynecology, Gilmore Memorial Regional Medical Center, 900 Earl Frye Blvd, Amory, MS, 38821, USA.
Jazyk: angličtina
Zdroj: Journal of robotic surgery [J Robot Surg] 2014 Mar; Vol. 8 (1), pp. 35-41. Date of Electronic Publication: 2013 Jul 03.
DOI: 10.1007/s11701-013-0418-z
Abstrakt: The aim of this study was to assess postoperative pain and narcotic use in the first 23 h following robotic versus traditional laparoscopic hysterectomy for benign pathology. The study design was that of a retrospective case-control study of robotic (first 100 consecutive) versus traditional (last 100 consecutive) total laparoscopic hysterectomy cases at an obstetrics and gynecology multi-institutional community practice. Patient characteristics were equivalent in both groups (age, p = 0.364; body mass index, p = 0.326; uterine weight, p = 0.565), except for a higher number of Caucasians in the traditional laparoscopic group (p = 0.017). Compared to patients who underwent robotic laparoscopic hysterectomy, those who underwent the traditional procedure had higher visual analog scale pain scores (3.1 ± 1.5 vs. 4.6 ± 2.4, respectively; p < 0.001) and used more narcotics (27.5 vs. 35.4 mg hydrocodone, respectively; p < 0.05). Factors that could potentially increase pain (more procedures, more ports, total incision size, and longer operative time) were significantly higher in the robotic group, but only surgical approach, amount of narcotic, and age correlated with pain levels when evaluated with regression analysis. Complication rates were equivalent between groups. In conclusion, patients who underwent robotic assisted laparoscopic hysterectomy had statistically decreased postoperative pain scores and narcotic use than those who underwent the traditional laparoscopic approach, even when the robotic cases involved more procedures and ports and were associated with longer operative time.
Databáze: MEDLINE