The Effect of Epidural Analgesia on Quality of Recovery (QoR) after Radical Prostatectomy

Abstract

No studies are currently regarding the quality of recovery (QoR) after open radical prostatectomy (ORP) and epidural morphine analgesia. This was a randomized, prospective, and controlled study that explored QoR on the first postoperative day after ORP. Sixty-one men were randomized into two groups. The first (epidural) group received general anesthesia combined with epidural anesthesia and postoperative epidural analgesia with morphine and ropivacaine. The second (control) group received general anesthesia and continuous postoperative intravenous analgesia with tramadol. Both groups received multimodal analgesia with metamizole. The primary outcome measure was the total QoR-40 score. Secondary outcome measures were: QoR-15, QoR-VAS and the visual analogue scale (VAS) for pain, anxiety and nausea. The median difference in the total QoR-40 score after 24 postoperative hours between the two groups of patients was 2 (95% CI: −3 to 8), p = 0.35. The global multivariate inference test for secondary outcomes between groups was not significant p > 0.05). QoR-VAS was correlated with QoR-40 (r = 0.69, p ≤ 0.001) and with QoR-15 (r = 0.65, p ≤ 0.001). The total QoR-40 and QoR-15 alpha coefficient with 95% CI was 0.88 (0.83-0.92) and 0.83 (0.77–0.89), respectively. There was no difference in the QoR between the epidural and the control group after ORP. The QoR-40 and QoR-15 showed good convergent validity and adequate reliability.

The Effect of Epidural Analgesia on Quality of Recovery (QoR) after Open Radical Nephrectomy: Randomized, Prospective, and Controlled Trial

“…There was no difference in the QoR-40 score between groups. The median QoR-40 score for both groups was 181 (177-188), and the median VAS pain on activity score was 40 [17]. A retrospective study by Kobari et al evaluated the QoR-40 after robot-assisted partial nephrectomy using a retroperitoneal or transperitoneal approach.…”

“…Morphine is a hydrophilic opioid that, given in epidural form, results in prolonged analgesia-up to 24 h [16]. Our previous work [17] evaluated epidural morphine analgesia and postoperative QoR-40 after radical prostatectomy.…”