Bupivacaine infiltration into the neurovascular bundle of the prostatic nerve does not improve postoperative pain or recovery following transvesical prostatectomy

Brian Fredman*, Edna Zohar, Toufic Ganim, Moshe Shalev, Robert Jedeikin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Purpose: We assessed the effect of intraoperative bupivacaine infiltration into the neurovascular bundle of the prostatic nerve on postoperative pain and patient outcome. Materials and Methods: The study included 40 American Society of Anesthesiologists physical status I to III patients undergoing transvesical prostatectomy. Following surgical resection of the prostate the neurovascular bundle of the prostatic nerve was infiltrated with either 10 ml. bupivacaine 0.5% or saline. Postoperative pain intensity was assessed using a patient generated 100 mm. visual analog scale and a patient controlled analgesia device. Additional analgesic requirements, time to ambulation, length of hospitalization and return to normal activity were also recorded. Results: There were no differences in visual analog scale for pain, patient controlled analgesia demands or actual morphine delivered. Similarly, saline versus bupivacaine infiltration did not influence ambulation time (21.3 ± 2.7 versus 25.0 ± 11.8 hours, respectively), length of hospitalization (7.06 ± 0.8 versus 7.11 ± 0.6 days, respectively), return to normal activity (14.4 ± 8.8 versus 14.2 ± 8.2 days, respectively) or patient satisfaction. On postoperative days 1 and 2 more patients in the saline treatment group requested additional oral analgesia compared to the bupivacaine treatment group. However, no statistical difference was demonstrated. Conclusions: Following transvesical prostatectomy, prostatic nerve blockade has no beneficial effects on postoperative pain or patient outcome.

Original languageEnglish
Pages (from-to)154-157
Number of pages4
JournalJournal of Urology
Volume159
Issue number1
DOIs
StatePublished - Jan 1998

Keywords

  • Analgesics
  • Anesthesia, local
  • Bupivacaine
  • Pain, postoperative

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