Presentation Authors: Giovanni E. Cacciamani*, Nicola Menestrina, Marco Pirozzi, Paolo corsi, Davide De Marchi, Davide Inverardi, Tania Processali, Nicolo' Trabacchin, Mario de Michele, Alessandro Tafuri, Marco Sebben, Maria Angela Cerruto, Vincenzo De Marco, Filippo Migliorni, Antonio Benito Porcaro, Walter Artibani, Verona, Italy
Introduction: To determinate benefits of the association of local anaesthetic wounds infiltration and US-TAP-block with ropivacaine on postoperative pain, early recovery and hospital stay in patients undergoing robot assisted radical prostatectomy (RARP).
Methods: The study is double-blinded randomized controlled trial. Our hypothesis was that the association of wound infiltration and US-TAP block with Ropivacaine would decrease immediate post-operative pain and opioids use. Primary outcomes included postoperative pain and opioids demand during the hospital stay. Secondary outcomes were nausea/vomiting rate, stool passing time, use of pro-kinetics, length of hospital stay and 30-days readmission to the hospital for pain or other US-TAP-block related complications
Results: A total of 100 patients who underwent RARP were eligible for the analysis; 57 received the US-TAP block with 20 ml of 0.35% Ropivacaine (US-TAP-block group) and 43 did not receive US-TAP block (no-US-TAP group). All the patients received the local wound anaesthetic infiltration with 20 ml of 0.35% Ropivacaine. US-TAP block group showed a decreased mean NRS (2.7vs1.8; p=0.04) and reduced use of opioid (8 vs 2; p=0.01) in the first 24 h. Moreover, we found a shorter mean LOS (4.7 vs 4.2; p= 0.04) with a reduced use of pro-kinetics during the hospital stay (31 vs 12; p < 0.001). No US-TAP-block related complications to were reported.
Conclusions: Association of anaesthetic wound infiltration and US-TAP block with Ropivacaine as part of a multimodal analgesic regimen can be safely offered to patients undergoing RARP and ePLND. It improves the immediate post-operative pain control, reducing opioids administration and is associated to a decreased use of pro-kinetics and shorter hospital stay.