Evaluation of neuraxial analgesia on outcomes for patients undergoing robot assisted abdominal surgery

Following robot assisted abdominal surgery, the pain can be moderate in severity. Neuraxial analgesia may decrease the activity of the detrusor muscle, reduce the incidence of bladder spasm and provide effective somatic and visceral analgesia. In this systematic review, we assessed the role of neura...

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Bibliographic Details
Published in:Journal of clinical anesthesia 2024-08, Vol.95, p.111468, Article 111468
Main Authors: Greig, P., Sotiriou, A., Kailainathan, P., Carvalho, C.Y.M., Onwochei, D.N., Thurley, N., Desai, N.
Format: Article
Language:English
Subjects:
Abdomen
Abdomen - surgery
Abdominal surgery
Adult
Analgesia
Analgesia, Epidural - methods
Analgesics
Analgesics, Opioid - administration & dosage
Anesthesia, Spinal - adverse effects
Anesthesia, Spinal - methods
Bladder
Clinical decision making
Clinical trials
Collaboration
Colorectal surgery
Epidural
Epidural analgesia
Evidence-based medicine
Hospitals
Humans
Hypotension
Intervention
Laparoscopy
Length of stay
Morphine
Morphine - administration & dosage
Narcotics
Observational studies
Pain
Pain management
Pain Measurement
Pain, Postoperative - etiology
Pain, Postoperative - prevention & control
Patient satisfaction
Postoperative period
Pruritus
Randomized Controlled Trials as Topic
Regional anesthesia
Robot assisted abdominal surgery
Robotic Surgical Procedures - adverse effects
Robotic Surgical Procedures - methods
Robots
Spinal analgesia
Surgeons
Systematic review
Treatment Outcome
Urinary retention
Urological surgery
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Summary:Following robot assisted abdominal surgery, the pain can be moderate in severity. Neuraxial analgesia may decrease the activity of the detrusor muscle, reduce the incidence of bladder spasm and provide effective somatic and visceral analgesia. In this systematic review, we assessed the role of neuraxial analgesia in robot assisted abdominal surgery. Systematic review. Robot assisted abdominal surgery. Adults. Subsequent to a search of the electronic databases, observational studies and randomized controlled trials that assessed the effect of neuraxial analgesia instituted at induction of anesthesia or intraoperatively in adult and robot assisted abdominal surgery were considered for inclusion. The outcomes of observational studies as well as randomized controlled trials which were not subjected to meta-analysis were presented in descriptive terms. Meta-analysis was conducted if an outcome of interest was reported by two or more randomized controlled trials. We included 19 and 11 studies that investigated spinal and epidural analgesia in adults, respectively. The coprimary outcomes were the pain score at rest at 24 h and the cumulative intravenous morphine consumption at 24 h. Spinal analgesia with long acting neuraxial opioid did not decrease the pain score at rest at 24 h although it reduced the cumulative intravenous morphine consumption at 24 h by a mean difference (95%CI) of 14.88 mg (−22.13–-7.63; p 
ISSN:0952-8180
1873-4529
1873-4529
DOI:10.1016/j.jclinane.2024.111468