Pain intensity after robotic-assisted urological surgery: the PAIROU study an international prospective cohort study.

OBJECTIVE

Despite improvements in perioperative pain management protocols, severe postoperative pain is still a burden for many patients. To improve the prevention and treatment of postoperative pain, it must be accurately assessed for each procedure type. However, there is little data available assessing the pain levels after robot-assisted urological surgeries. This cohort study aimed to estimate the pain scores that can be expected after various types of robotic-assisted urologic procedures.

METHODS

This was a prospective, multicentre, observational trial in 44 centers in Europe that included patients scheduled for robotic-assisted urological surgery. The primary outcome was pain scores on the first day after surgery assessed using the numeric rating scale (NRS). Secondary outcomes included pain score on the second day after surgery, morphine equivalent consumption in mg 48 h after the surgery, postoperative nausea and vomiting (PONV), and surgical complications.

RESULTS

A total of 965 patients were recruited between November 2022 and June 2023. Median pain score on postoperative day 1 was 2 at rest (IQR, 0-4) (n = 963) and 3 with movement (IQR, 1-5) (n = 921). Morphine equivalent consumption 48 h after the surgery was 4 mg (IQR 0-20 mg). PONV was experienced by 16 % of the patients (153/963).

CONCLUSION

This large cohort study demonstrates that patients experience low pain scores and require low opioids after robotic-assisted urological surgery when commonly used multimodal analgesia protocols are administered.

TRIAL REGISTRATION: clinicaltrials.gov No. NCT05575284.