4.7 Article

The Effect of Epidural Analgesia on Quality of Recovery (QoR) after Radical Prostatectomy

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JOURNAL OF PERSONALIZED MEDICINE
卷 13, 期 1, 页码 -

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MDPI
DOI: 10.3390/jpm13010051

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quality of recovery; radical prostatectomy; general anesthesia; epidural anesthesia; postoperative analgesia; morphine; ropivacaine; tramadol; multimodal analgesia

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This study compared the quality of recovery after open radical prostatectomy between two groups of patients. The results showed no significant difference in recovery between the group receiving epidural anesthesia and analgesia and the group receiving intravenous analgesia.
No studies are currently regarding the quality of recovery (QoR) after open radical prostatectomy (ORP) and epidural morphine analgesia. This was a randomized, prospective, and controlled study that explored QoR on the first postoperative day after ORP. Sixty-one men were randomized into two groups. The first (epidural) group received general anesthesia combined with epidural anesthesia and postoperative epidural analgesia with morphine and ropivacaine. The second (control) group received general anesthesia and continuous postoperative intravenous analgesia with tramadol. Both groups received multimodal analgesia with metamizole. The primary outcome measure was the total QoR-40 score. Secondary outcome measures were: QoR-15, QoR-VAS and the visual analogue scale (VAS) for pain, anxiety and nausea. The median difference in the total QoR-40 score after 24 postoperative hours between the two groups of patients was 2 (95% CI: -3 to 8), p = 0.35. The global multivariate inference test for secondary outcomes between groups was not significant p > 0.05). QoR-VAS was correlated with QoR-40 (r = 0.69, p <= 0.001) and with QoR-15 (r = 0.65, p <= 0.001). The total QoR-40 and QoR-15 alpha coefficient with 95% CI was 0.88 (0.83-0.92) and 0.83 (0.77-0.89), respectively. There was no difference in the QoR between the epidural and the control group after ORP. The QoR-40 and QoR-15 showed good convergent validity and adequate reliability.

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