Abstract
Background
Robot-assisted urologic surgery is associated with reduced intraoperative bleeding and shortened hospital stays; however, postoperative pain remains concerning. Thus, the authors investigated whether intraoperative sufentanil is more effective than remifentanil in reducing postoperative pain and analgesic consumption.Methods
Patients undergoing robot-assisted urologic surgery (March 2023 to March 2024) were divided into the sufentanil or remifentanil groups and matched by propensity score. The primary outcome was the distribution of pain severity after surgery. Secondary outcomes included pain scores and rescue analgesic consumption.Results
Among 832 eligible patients, 194 were matched from each group. The distribution of pain severity after surgery was significantly different between groups (rank-biserial correlation -0.34, 95% confidence interval [CI] -0.43 to -0.24; P vs. 4.6%, risk difference [RD] 23.2%, 95% CI 16.2% to 30.2%; P vs. 57.2%, RD -24.7%, 95% CI -34.3% to -15.2%; P vs. 7 [6, 8], Hodges-Lehmann estimator [HL estimator] -1, 95% CI -2 to -1; P vs. 20 [10, 29.6] mg of morphine-equivalent dose, HL estimator -5 mg, 95% CI -6.7 to -2.5 mg; P Conclusions
Intraoperative sufentanil was associated with lower postoperative pain and analgesic consumption than was remifentanil in patients undergoing robot-assisted urologic surgery.