An Enhanced Recovery After Surgery protocol for robotic-assisted laparoscopic nephrectomies utilizing a quadratus lumborum block

Yip, Wesley; Chen, Andrew B.; Malekyan, Cristin; Widjaja, W.; Yan, Kevin; Stankey, Makela; Sun, Xue; Ashrafi, Akbar; Graham, J.; Dickerson, Shane; Eloustaz, Mohamed H; Desai, Mihir; Gill, Inderbir S.; Aron, Monish; Kim, Michael P.

doi:10.1007/s11701-022-01379-9

Cited by 6 publications

(4 citation statements)

References 23 publications

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“…8 Similarly, another study evaluated opioid consumption and perioperative outcomes before and after ERAS protocol initiation, which utilized multimodal analgesia including acetaminophen and gabapentin and found lower opioid consumption on postoperative days 0, 1, and 2 in the ERAS group. 15 These results are promising in terms of nonopioid treatment options, however fail to specifically evaluate gabapentin’s impact by isolating it from the other components of the multimodal pain regimen as our study did.…”

Section: Discussionmentioning

confidence: 79%

Gabapentin and Rapidity of Recovery Among Patients Undergoing Minimally Invasive Ambulatory Uro-Oncologic Surgeries

Kohilakis,

Assel,

Serafin

et al. 2024

Urology Practice

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Section: Discussionmentioning

confidence: 79%

Gabapentin and Rapidity of Recovery Among Patients Undergoing Minimally Invasive Ambulatory Uro-Oncologic Surgeries

Kohilakis,

Assel,

Serafin

et al. 2024

Urology Practice

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“…Un estudio observacional retrospectivo reciente, realizado en pacientes sometidos a nefrectomía parcial asistida por robot con bloqueo del cuadrado lumbar se encontró una diferencia significativa respecto al uso de opioides de rescate al día 0, 1 y 2 de la cirugía. No obstante, no especifican los resultados para el posoperatorio inmediato [29]. En la misma línea, un ensayo clínico aleatorizado en pacientes sometidos al mismo procedimiento, encontró una diferencia significativa en la disminución del dolor, según la EVA, del bloqueo lumbar en comparación a placebo, a las 6 h después de la cirugía [30].…”

Section: Discussionunclassified

Bloqueos de pared abdominal en nefrectomía parcial asistida por robot

Astudillo,

Rearte,

Rigo-Righi

et al. 2023

Rev. chil. anest.

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“…Studies in various other types of surgeries consistently show superiority of the QL block over the TAP block. Additionally, QL blocks have been used as part of ERAS protocols for robotic urologic surgeries [21]. Our patient required a total of 100 mcg of fentanyl and 0.6 mg of hydromorphone intraoperatively to maintain comfort under anesthesia.…”

Section: Discussionmentioning

confidence: 99%

The Use of Enhanced Recovery After Surgery Protocols and Sugammadex in a Friedreich Ataxia Patient Who Underwent Robotic Surgery: A Case Report of a Patient Who Required No Postoperative Opioids and Was Discharged Home Earlier Than Anticipated

Russo¹,

Haddad²,

Bauman³

et al. 2022

Cureus

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Robotic surgery has shown to have numerous benefits over traditional and laparoscopic surgery, namely, superior precision and improved recovery with shorter hospital stays. However, robotic surgery also presents several issues, including hemodynamic changes related to positioning and the use of pneumoperitoneum. These matters can be problematic in patients with neuromuscular conditions such as Friedreich ataxia (FRDA). Due to a baseline weakened musculature and a higher prevalence of cardiac disease and scoliosis, patients with FRDA may not be as likely to tolerate the cardiopulmonary physiologic changes associated with robotic surgery. Additionally, positioning for robotic surgery can be challenging in FRDA patients who have progressed to spasticity and contractures. To the best of our knowledge, there are no case reports of approaches specifically discussing anesthesia management for robotic surgery in the FRDA patient population.Anesthesia in general must be carefully planned in FRDA patients to allow for the best possible recovery and minimize complications. Due to the underlying neuromuscular compromise seen in these patients, their ability to recover from the pharmacologic and physiologic changes associated with anesthesia can be more difficult. They are prone to sensitivity to opioids, sedatives, and neuromuscular blocking agents (NMBAs) and are less likely to tolerate hemodynamic changes. Our review revealed no literature to suggest the routine use of Enhanced Recovery After Surgery (ERAS) protocols in FRDA patients or in patients with neuromuscular disease in general.The use of sugammadex has also been shown to be safe, and literature suggests superiority in both the general population and those with neuromuscular conditions. Our understanding is that there is very limited literature in regard to the safe use of sugammadex in FRDA patients.

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An Enhanced Recovery After Surgery protocol for robotic-assisted laparoscopic nephrectomies utilizing a quadratus lumborum block

Cited by 6 publications

References 23 publications

Gabapentin and Rapidity of Recovery Among Patients Undergoing Minimally Invasive Ambulatory Uro-Oncologic Surgeries

Gabapentin and Rapidity of Recovery Among Patients Undergoing Minimally Invasive Ambulatory Uro-Oncologic Surgeries

Bloqueos de pared abdominal en nefrectomía parcial asistida por robot

The Use of Enhanced Recovery After Surgery Protocols and Sugammadex in a Friedreich Ataxia Patient Who Underwent Robotic Surgery: A Case Report of a Patient Who Required No Postoperative Opioids and Was Discharged Home Earlier Than Anticipated

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