MP80-04 NON-NARCOTIC REGIMEN CENTERED ON PREOPERATIVE ERECTOR SPINAE PLANE (ESP) BLOCKS FOR ROBOT-ASSISTED RADICAL PROSTATECTOMY DRASTICALLY REDUCES ADMINISTERED POSTOP MORPHINE EQUIVALENTS

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP80-04 NON-NARCOTIC REGIMEN CENTERED ON PREOPERATIVE ERECTOR SPINAE PLANE (ESP) BLOCKS FOR ROBOT-ASSISTED RADICAL PROSTATECTOMY DRASTICALLY REDUCES ADMINISTERED POSTOP MORPHINE EQUIVALENTS Aaron Saxton, Deaton Jones, Adam Visca, Kaitlyn Mitchell, Danielle Lindenmuth, Christopher Wanderling, Austin Lee, and Thomas P. Frye Aaron SaxtonAaron Saxton More articles by this author , Deaton JonesDeaton Jones More articles by this author , Adam ViscaAdam Visca More articles by this author , Kaitlyn MitchellKaitlyn Mitchell More articles by this author , Danielle LindenmuthDanielle Lindenmuth More articles by this author , Christopher WanderlingChristopher Wanderling More articles by this author , Austin LeeAustin Lee More articles by this author , and Thomas P. FryeThomas P. Frye More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003357.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Robot-assisted radical prostatectomy (RARP) is associated with improved postoperative pain control and reduced opioid requirements compared with open surgery. Recent literature has shown a decreased need for narcotic use in the post-operative period. However, there is still question over the optimal pain regimen. Our study evaluates a non-narcotic regimen for patients undergoing RARP that centers on preoperative erector spinae plane (ESP) blocks. METHODS: In association with the Department of Anesthesiology, a non-narcotic analgesic pathway was created for patients undergoing RARPs. The pathway was centered on an ESP block and replacing narcotics with multi-modal analgesia post-operatively. After IRB approval, a retrospective cohort of patients who received narcotics post-operatively and no ESP block pre-operatively was compared to a prospective cohort of patients who underwent the non-narcotic pathway. Narcotics were available for patients in the non-narcotic group if their pain was not controlled. Patients were excluded from the non-narcotic group if NSAIDs were contraindicated, if they were taking narcotics, or if they underwent a concomitant procedure at the time of RARP. Nursing pain scores were recorded for each patient, as well as post-operative morphine equivalents received, if narcotic was prescribed for home, the amount of morphine equivalents prescribed for home, and the need for any narcotic refills. RESULTS: 163 patients were in the narcotic group compared to 131 in the non-narcotic group. There was a statistically significant difference in average post-operative pain scores between the narcotic and non-narcotic groups (3.5 vs. 2.4, p<0.001) and a statistically significant difference in postoperative morphine equivalents delivered (49.4 vs. 7.4, p<0.001). In addition, only 17 patients in the non-narcotic group were discharged with a narcotic prescription for home, compared to 161 in the narcotic cohort (13.0% vs, 98.8%, p<0.001). The average length of stay was lower in the non-narcotic group (1.1 vs 1.3, p<0.001). No adverse patient events resulted from the block. CONCLUSIONS: A non-narcotic analgesic pathway centered on pre-operative ESP blocks decreased both post-operative pain scores and post-operative morphine equivalents received in patients who underwent RARP, providing an additional modality to aid in optimal, non-narcotic analgesia. Source of Funding: N/a © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1152 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Aaron Saxton More articles by this author Deaton Jones More articles by this author Adam Visca More articles by this author Kaitlyn Mitchell More articles by this author Danielle Lindenmuth More articles by this author Christopher Wanderling More articles by this author Austin Lee More articles by this author Thomas P. Frye More articles by this author Expand All Advertisement PDF downloadLoading ...