Impact of analgesic techniques on early quality of recovery after prostatectomy: a 3‐arm, randomised trial

Impact of analgesic techniques on early quality of recovery after prostatectomy: a 3‐arm, randomised trial. Beilstein CM, Huber M, Furrer MA, Löffel LM, Wuethrich PY, Engel D. European Journal of Pain. Epub 2022 Aug 12

What is already known:

Analgesic strategies after prostatectomy vary international and nationally between institutions. Strategies include opiates, ketamine, clonidine and gabapentoinds, and potential the inclusion of a regional and central neuraxial techniques, with transversus abdominus plane (TAP) blocks and spinal anaesthetics being the most commonly employed techniques respectively.

What this paper adds:

This paper utilises a holistic review of post-operative recovery, utilising a Quality of Recovery questionnaire rather than focussing on pain scores. As such, the results of this study are difficult to compare to those focussed on pain scores or analgesic requirements.
The protocol compares 3 analgesic strategies in a prospective, randomised, 3 arm, parallel group superiority trial. It compares a single shot spinal technique, TAP blocks and the control group receiving systemic analgesia with an IV lidocaine bolus and infusion for 24hours. All patient arms received ketorolac, paracetamol and metamizol. No statistical difference was identified between techniques, either at day one or discharge. This facilitates clinicians choosing techniques which fit their institution.