Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/12025
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dc.contributor.authorMir, Maria Cen
dc.contributor.authorJoseph, Binoyen
dc.contributor.authorZhao, Ronaen
dc.contributor.authorBolton, Damien Men
dc.contributor.authorGyomber, Dennisen
dc.contributor.authorLawrentschuk, Nathan Len
dc.date.accessioned2015-05-16T01:39:40Z
dc.date.available2015-05-16T01:39:40Z
dc.date.issued2013-10-21en
dc.identifier.citationResearch and Reports in Urology 2013; 5(): 139-45en
dc.identifier.govdoc24400245en
dc.identifier.otherPUBMEDen
dc.identifier.urihttp://ahro.austin.org.au/austinjspui/handle/1/12025en
dc.description.abstractOur objectives were to analyze the effectiveness of epidural anesthesia in patients who underwent open retropubic radical prostatectomy (RRP) at our institution over the past decade, and to examine subsequent oncologic outcomes, comparing those receiving with those not receiving epidural anesthesia.A comprehensive database of all patients undergoing RRP from November 1996 to December 2006 was analyzed; 354 patients underwent RRP at our institution and were divided into those receiving or not receiving an epidural. An independent pain management team scoring technical success found epidural technique to be consistent. Oncological outcome was an endpoint of our study, comparing both analysis groups. We classed prostate-specific antigen (PSA) recurrence after RRP as a serum PSA ≥ 0.2 ng/mL at any stage of postoperative follow-up. Complications were recorded to 30 days using the modified Clavien system, and full statistical analyses were undertaken.Records were available for 239 men; we observed a decreased trend in the use of epidural for pain management, along with a decrease in average hospital stay and an overall epidural success rate of 64%. When dividing data into RRP with and without epidural, we found a median hospital stay of 7 days for patients receiving an epidural compared with 6 days for those not receiving an epidural. The differences were statistically significant (P < 0.048) and remained so after adjusting for complications (P < 0.0001). Regarding oncological outcome, PSA recurrence was further analyzed in this cohort. Percentage of recurrence was higher (14.8%) for patients receiving an epidural than for the non-epidural group (4.8%). The differences were statistically significant (P = 0.012).Epidural analgesia increased length of hospital stay and technical problems related to the epidural. Furthermore, men receiving an epidural showed an increased recurrence of PSA. In light of our findings, epidurals are probably not indicated for men undergoing RRP. However, as minimally invasive techniques are becoming more widespread, and epidural analgesia is being used less frequently, large randomized controlled trials to definitively support our hypotheses are unlikely to be undertaken.en
dc.language.isoenen
dc.subject.otheranalgesiaen
dc.subject.otherepiduralen
dc.subject.otherprostate neoplasmen
dc.subject.otherprostatectomyen
dc.subject.othersurgeryen
dc.titleEffectiveness of epidural versus alternate analgesia for pain relief after radical prostatectomy and correlation with biochemical recurrence in men with prostate cancer.en
dc.typeJournal Articleen
dc.identifier.journaltitleResearch and reports in urologyen
dc.identifier.affiliationUniversity of Melbourne, Department of Surgery, Austin Hospital, Melbourne, VIC, Australia ; Ludwig Institute for Cancer Research, Austin Hospital, Melbourne, VIC, Australiaen
dc.identifier.affiliationUniversity of Melbourne, Department of Surgery, Austin Hospital, Melbourne, VIC, Australiaen
dc.identifier.doi10.2147/RRU.S49219en
dc.description.pages139-45en
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pubmed/24400245en
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