Novel Multi-Modal Analgesia Protocol Significantly Decreases Opioid Requirements in Inflatable Penile Prosthesis Patients

The Journal of Sexual Medicine
Ching Man Carmen TongJay Simhan

Abstract

Inflatable penile prosthesis (IPP) surgery is associated with significant perioperative pain that may reduce patient satisfaction. Though various pain management strategies have been proposed, most implanters manage postoperative patients with only prescription opioids. No protocol to date has been implemented and reported for pain management in IPP patients throughout the entire recovery process following surgery. Develop a multimodal analgesic (MMA) regimen consisting of perioperative administration of acetaminophen, meloxicam, and gabapentin with intraoperative local anesthetic injections, and compare post-operative pain control to a matched cohort of patients managed with an opioid-based (OB) regimen. We retrospectively analyzed our prospectively maintained IPP database from November 2015-January 2018. The MMA protocol was instituted for all patients beginning June 2017, and these patients were matched in a 1:2 ratio to a cohort of eligible IPP patients managed through an OB protocol. Only patients receiving a 3-piece IPP were included; those with a history of narcotic dependence, neuropathy, or chronic non-steroidal anti-inflammatory drug use were excluded. Postoperative pain scores (visual analog scale) and opioid usage (...Continue Reading

Citations

Feb 8, 2019·Current Urology Reports·Charles Welliver
Jul 25, 2019·Current Opinion in Anaesthesiology·Amanda H Kumar, Ashraf S Habib
Mar 24, 2020·International Journal of Impotence Research·Soum D LokeshwarRanjith Ramasamy
Mar 5, 2019·F1000Research·Mathew Q FakhouryNelson Bennett
Feb 4, 2021·Current Urology Reports·Jeffrey L EllisJay Simhan

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