Spinal analgesia improves surgical outcome after open nephrectomy for renal cell carcinoma: a randomized controlled study

Scandinavian Journal of Urology
Mascha ThurmBörje Ljungberg

Abstract

This study evaluated whether more effective perioperative analgesia can be part of a multimodal approach to minimizing morbidity and improving postoperative management after the open surgical approaches frequently used in the treatment of renal cell carcinoma (RCC). The aim of the study was to determine whether spinal anesthesia with clonidine can enhance postoperative analgesia, speed up mobilization and reduce the length of hospital stay (LOS). Between 2012 and 2015, 135 patients with RCC were randomized, in addition to general anesthesia, to receive either spinal analgesia with clonidine or epidural analgesia, stratified to surgical technique. Inclusion criteria were American Society of Anesthesiologists (ASA) score of III or less, age over 18 years and no chronic pain medication or cognitive disorders. The median LOS was 4 days for patients in the spinal group and 6 days in the epidural group (p = 0.001). There were no differences regarding duration of surgery, blood loss, RENAL score, tumor size or complications between the given analgesia methods. A limitation was that different anesthesiologists were responsible for administering spinal or epidural anesthesia, as in a real-world clinical situation. In this randomized con...Continue Reading

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Jan 27, 2015·European Urology·Borje LjungbergAxel Bex
Jul 24, 2015·Scandinavian Journal of Urology·Andreas ThorstensonUNKNOWN Swedish Kidney Cancer Quality Register Group

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Citations

Feb 6, 2018·BJU International·Joana B NevesUNKNOWN British Association of Urological Surgeons (BAUS)

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