TY - JOUR
T1 - Optimal pain management for radical prostatectomy surgery
T2 - What is the evidence?
AU - on behalf of the PROSPECT collaboration
AU - Joshi, Grish P.
AU - Jaschinski, Thomas
AU - Bonnet, Francis
AU - Kehlet, Henrik
AU - Barrie, H.
AU - Fischer, J.
AU - Hill, Andrew
AU - Lirk, Philipp
AU - Neugebauer, Edmund A M
AU - Rawal, Narinder
AU - Schug, Stephan A.
AU - Simanski, Christian J P
AU - Van de Velde, Marc
AU - Vercauteren, Marcel
N1 - Publisher Copyright:
© 2015 Joshi et al.
PY - 2015/11/4
Y1 - 2015/11/4
N2 - Background: Increase in the diagnosis of prostate cancer has increased the incidence of radical prostatectomy. However, the literature assessing pain therapy for this procedure has not been systematically evaluated. Thus, optimal pain therapy for patients undergoing radical prostatectomy remains controversial. Methods: Medline, Embase, and Cochrane Central Register of Controlled Trials were searched for studies assessing the effects of analgesic and anesthetic interventions on pain after radical prostatectomy. All searches were conducted in October 2012 and updated in June 2015. Results: Most treatments studied improved pain relief and/or reduced opioid requirements. However, there were significant differences in the study designs and the variables evaluated, precluding quantitative analysis and consensus recommendations. Conclusions: This systematic review reveals that there is a lack of evidence to develop an optimal pain management protocol in patients undergoing radical prostatectomy. Most studies assessed unimodal analgesic approaches rather than a multimodal technique. There is a need for more procedure-specific studies comparing pain and analgesic requirements for open and minimally invasive surgical procedures. Finally, while we wait for appropriate procedure specific evidence from publication of adequate studies assessing optimal pain management after radical prostatectomy, we propose a basic analgesic guideline.
AB - Background: Increase in the diagnosis of prostate cancer has increased the incidence of radical prostatectomy. However, the literature assessing pain therapy for this procedure has not been systematically evaluated. Thus, optimal pain therapy for patients undergoing radical prostatectomy remains controversial. Methods: Medline, Embase, and Cochrane Central Register of Controlled Trials were searched for studies assessing the effects of analgesic and anesthetic interventions on pain after radical prostatectomy. All searches were conducted in October 2012 and updated in June 2015. Results: Most treatments studied improved pain relief and/or reduced opioid requirements. However, there were significant differences in the study designs and the variables evaluated, precluding quantitative analysis and consensus recommendations. Conclusions: This systematic review reveals that there is a lack of evidence to develop an optimal pain management protocol in patients undergoing radical prostatectomy. Most studies assessed unimodal analgesic approaches rather than a multimodal technique. There is a need for more procedure-specific studies comparing pain and analgesic requirements for open and minimally invasive surgical procedures. Finally, while we wait for appropriate procedure specific evidence from publication of adequate studies assessing optimal pain management after radical prostatectomy, we propose a basic analgesic guideline.
KW - Multimodal analgesia
KW - Pain
KW - Postoperative
KW - Radical prostatectomy
UR - http://www.scopus.com/inward/record.url?scp=84946202943&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84946202943&partnerID=8YFLogxK
U2 - 10.1186/s12871-015-0137-2
DO - 10.1186/s12871-015-0137-2
M3 - Article
C2 - 26530113
AN - SCOPUS:84946202943
SN - 1471-2253
VL - 15
JO - BMC Anesthesiology
JF - BMC Anesthesiology
IS - 1
M1 - 159
ER -