Anaesthetic management for robotic-assisted laparoscopic prostatectomy: the first UK national survey of current practice

• DOI: 10.1007/s11701-020-01105-3
• Publication Date: 2020-06-24T10:02:44Z
• Authors: D. Milliken; H. Lawrence; M. Brown; D. Cahill; D. Newhall; D. Barker; R. Ayyash; R. Kasivisvanathan
• Keywords: Male; Prostatectomy; Length of Stay; Anesthesia, Spinal; Hospitals; United Kingdom; 3. Good health; Heroin; 03 medical and health sciences; 0302 clinical medicine; Robotic Surgical Procedures; Surveys and Questionnaires; Anesthesia, Intravenous; Humans; Anesthesia; Laparoscopy; Enhanced Recovery After Surgery

Robotic-assisted laparoscopic prostatectomy (RALP) is the most common robotic surgical procedure, but there are little published data to inform anaesthetic practice. We aimed to characterise the range of anaesthetic practice for RALP in the United Kingdom through a national survey. We conducted an online national survey to determine current anaesthetic practice for RALP. The survey was distributed to all NHS hospitals within the UK that perform RALP. Thirty-four (79%) of 43 hospitals responded to the survey. Fourteen (41%) centres routinely provide spinal anaesthesia and 79% of these use diamorphine as their intrathecal opioid of choice. Thirty-one (91%) centres administer intravenous strong opioids intraoperatively, and a wide range of non-opioid analgesic agents are also administered. Five (15%) centres reported that they discharge a minority of patients on the day of surgery. High-volume centres are more likely to have a formalised enhanced recovery after surgery (ERAS) pathway and to provide ambulatory surgery for selected patients. This represents the first UK national survey of anaesthetic practice for RALP. The results of the survey revealed significant variation in anaesthetic practice implying a lack of consensus on best perioperative management.