From the Journals

Lower analgesic use after robotic pelvic surgery



Postoperative use of both opioid and nonopioid analgesics was lower after robotic surgery than after laparotomy for endometrial cancer, according to a report published in Gynecologic Oncology.

Minimally Invasive Robotic Surgery with the da Vinci Surgical System. Master Video/Shutterstock

Shown is minimally invasive robotic surgery with the da Vinci Surgical System.

Compared with an historical cohort of 59 women matched for age and cancer stage who underwent laparotomy at the same medical center in earlier years, the robotic cohort required significantly less opioids (12 mg vs. 71 mg), acetaminophen (2,151 mg vs. 4,810 mg), ibuprofen (377 mg vs. 1,892 mg), and naproxen (393 mg vs 1,470 mg). In addition, no patients who underwent robotic surgery required continuous epidural anesthesia, and only 2% used patient-controlled analgesia, compared with 9% and 90% of patients who underwent laparotomy.

This benefit in the use of pain medication occurred regardless of the patient’s obesity status or age, which is particularly helpful in view of the increased risk of adverse events in these two patient populations, Dr. Abitbol and his associates reported (Gynecol Oncol. 2016. doi: 10.1016/jgyno.2016.11.014).

The direct costs associated with postoperative analgesia also were commensurately lower for robotically assisted surgery ($2.52 per day) than for laparotomy ($7.89 per day).

This study was supported by grants from the Israel Cancer Research Foundation, the Gloria’s Girls Fund, the Levi Family Fund, and the Weekend to End Women’s Cancers. Dr. Abitbol reported having no relevant financial disclosures; one of his associates reported receiving a grant from Intuitive Surgical.

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