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Postoperative Analgesia and Recovery After Open and Laparoscopic Prostatectomy

Atallah, Fouad MD*; Khedis, M MD; Seguin, P MD; Fourcade, O MD, PhD*; Samii, K MD*

doi: 10.1213/01.ANE.0000139734.23015.25
Letters to the Editor: Letters & Announcements

Departments of *Anesthesiology and Intensive Care and †Urology; Rangueil-Toulouse University Hospitals; Toulouse, France;

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To the Editor:

We compared the postoperative recovery and requirement of analgesia between open radical prostatectomy (ORP), which is the surgical technique of reference for treatment of early prostatic carcinoma, and laparoscopic radical prostatectomy (LRP), which has been recently introduced (Table 1).

Table 1

Table 1

A total of 174 patients had undergone radical prostatectomy over a period of 31/2 years in two hospitals. Postoperative analgesia was regularly maintained with 8 g of propacetamol daily, completed as required by patient with morphine either using patient-controlled analgesia device or by subcutaneous injections.

LRP needed a significant longer operative time than ORP but allowed a more rapid patient recovery and earlier hospital discharge. Postoperative pain, as assessed by adjuvant morphine consumption was less in LRP group, but surprisingly, this difference was not significant. Other studies had previously found a significant lower need of analgesia with LRP (1). This difference could be explained by the small transverse suprapubic incision (Pfannenstiel’s incision) regularly used for ORP by our surgeons, and which had been reported to produce much less tension on the abdominal wall than vertical incisions usually used for this surgery (2).

We conclude that LRP is a comparable technique to ORP as regards postoperative need of analgesia; however, it is associated with a shorter postoperative recovery and hospital stay.

Fouad Atallah, MD

M. Khedis, MD

P. Seguin, MD

O. Fourcade, MD, PhD

K. Samii, MD

Departments of *Anesthesiology and Intensive Care and †Urology

Rangueil-Toulouse University Hospitals

Toulouse, France

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1. Rassweiler J, Seemann O, Schulze M, et al. Laparoscopic versus open radical prostatectomy: a comparative study at a single institution. J Urol 2003;169:1689–93.
2. Daversa B, Landers D. Physiological advantages of the transverse incision in gynecology. Obstet Gynecol 1961;17:305–10.
© 2004 International Anesthesia Research Society