Impact of Intraoperative Opioid Use and a Combined Anesthesia Regimen in Patients Undergoing Radical Prostatectomy for Prostate Cancer in a Single-Center Cohort
2024

Impact of Opioid Use and Anesthesia in Prostate Cancer Surgery

Sample size: 1137 publication 10 minutes Evidence: moderate

Author Information

Author(s): Marcon Julian, Bischoff Robert, Rattenhuber Kaspar, Chaloupka Michael, Askari Darjusch, Jokisch Jan-Friedrich, Becker Armin J., Pfitzinger Paulo L., Keller Patrick, Berg Elena, Stief Christian G., Siegl Daniel, Kowalski Christian, Buchner Alexander, Pyrgidis Nikolaos, Weinhold Philipp, Hollmann Markus W., Kim Won Ho

Primary Institution: Department of Urology, University Hospital of the LMU Munich

Hypothesis

Higher doses of intraoperative opioids may negatively affect long-term oncological outcomes after radical prostatectomy.

Conclusion

Intraoperative opioid application during radical prostatectomy has no negative impact on prognosis in patients with localized prostate cancer.

Supporting Evidence

  • 93% of patients received total intravenous anesthesia (TIVA).
  • 24% of patients developed biochemical recurrence after a median follow-up of 431 days.
  • 2.9% of patients died after a median follow-up of 500 days.
  • Type of anesthesia did not affect biochemical recurrence or overall survival.
  • Patients receiving higher doses of opioids had similar outcomes compared to those with lower doses.

Takeaway

This study found that using opioids during prostate cancer surgery doesn't seem to harm patients in the long run, no matter how much is used.

Methodology

Patients undergoing radical prostatectomy were analyzed for the impact of intraoperative opioid doses and anesthesia type on biochemical recurrence and survival.

Potential Biases

Potential bias due to uneven distribution of anesthesia types among patients.

Limitations

The study was limited by its single-center design and the exclusion of patients with metastatic prostate cancer.

Participant Demographics

Median age of participants was 66 years, with a significant proportion having locally advanced disease.

Statistical Information

Confidence Interval

95% CI: 0.45 to 1.46

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.3390/jcm13247506

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