Liposomal Bupivacaine Decreases Postoperative Length of Stay and Opioid Use in Patients Undergoing Radical Cystectomy.

Abstract:

OBJECTIVE:To analyze differences in length of stay, opioid use, and other perioperative outcomes in patients undergoing radical cystectomy with urinary diversion who received either liposomal bupivacaine (LB) or epidural analgesia. METHODS:This was a single center, retrospective cohort study of patients undergoing open radical cystectomy with urinary diversion from 2015-2019 in the early recovery after surgery (ERAS) pathway. Patients received either LB or epidural catheter analgesia for post-operative pain control. LB was injected at the time of fascial closure to provide up to 72 hours of local analgesia. The primary outcome was post-operative length of stay. Secondary outcomes were post-operative opioid use, time to solid food, time to ambulation, and direct hospitalization costs. Multivariable Cox proportional hazards regression was used to determine associations between analgesia type and discharge. RESULTS:LB use was independently associated with shorter post-operative length of stay compared to epidural use (median (IQR) 4.9 days (3.9-5.8) vs 5.9 days (4.9-7.9), P<.001), less total opioid use (mean 188.3 vs 612.2 OME, P <.001), earlier diet advancement (mean 1.6 vs 2.4 days, P <.001), and decreased overall direct costs ($23,188 vs $29,628, P <.001). 45% of patients who received LB were opioid-free after surgery, none in the epidural group. On multivariable Cox proportional hazards regression modeling, LB use was independently associated with earlier discharge (HR 2.1, IQR 1.0-4.5). CONCLUSION:Use of LB in open radical cystectomy is associated with reduced LOS, less opioid exposure, and earlier diet advancement.

journal_name

Urology

journal_title

Urology

authors

Chu CE,Law L,Zuniga K,Lin TK,Tsourounis C,Rodriguez-Monguio R,Lazar A,Washington SL 3rd,Cooperberg MR,Greene KL,Carroll PR,Pruthi RS,Meng MV,Chen LL,Porten SP

doi

10.1016/j.urology.2020.11.036

subject

Has Abstract

pub_date

2020-12-03 00:00:00

eissn

0090-4295

issn

1527-9995

pii

S0090-4295(20)31426-6

pub_type

杂志文章

相关文献

UROLOGY文献大全
  • Wound infiltration with bupivacaine and intramuscular diclofenac reduces postoperative tramadol consumption in patients undergoing radical retropubic prostatectomy: a prospective, double-blind, placebo-controlled, randomized study.

    abstract:OBJECTIVES:To assess the impact of wound infiltration with bupivacaine and i.m. diclofenac administration on patient-controlled analgesia (PCA) tramadol consumptions and postoperative pain in patients who underwent radical retropubic prostatectomy (RRP) under general anesthesia. Previous studies have found only limited...

    journal_title:Urology

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.urology.2011.07.1428

    authors: Bilgin TE,Bozlu M,Atici S,Cayan S,Tasdelen B

    更新日期:2011-12-01 00:00:00

  • Arterial embolization of bleeding pseudoaneurysm caused by percutaneous renal biopsy.

    abstract::A pseudoaneurysm of a primary branch of the renal artery with massive hemorrhage developed in a patient who underwent percutaneous needle renal biopsy. He was treated successfully by embolization of the artery with gelatin sponge (Gelfoam). ...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/0090-4295(79)90508-9

    authors: Uretzky G,Shapiro A,Ring E

    更新日期:1979-09-01 00:00:00

  • Uroflow Stop Test and Potency Recovery: A Surrogate for Pelvic Floor Integrity Post Robotic-Assisted Radical Prostatectomy?

    abstract:OBJECTIVE:To study the relation between uroflow Stop Test and early recovery of potency following robot-assisted radical prostatectomy (RARP). We recently showed that the ability to completely stop urine flow during voiding, measured objectively by uroflowmetry at the time of catheter removal (uroflow Stop Test) can pr...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2015.05.041

    authors: Alenizi AM,Bienz M,Rajih E,Alesawi A,Al-Hathal N,Benayoun S,Lebeau T,Zorn KC,El-Hakim A

    更新日期:2015-10-01 00:00:00

  • Role of preoperative urography in benign prostatic hyperplasia.

    abstract::The excretory urograms of 184 consecutive patients admitted to hospital with a diagnosis of benign prostatic hyperplasia who subsequently underwent prostatectomy were reviewed to determine the usefulness of preoperative urography. Of 184 urograms reviewed, 10 were normal, 136 showed changes consistent with benign pros...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/0090-4295(79)90507-7

    authors: Pang SM,Keresteci AG,Rankin JT,Jewett MA

    更新日期:1979-09-01 00:00:00

  • Use and abuse of retrograde pyelography.

    abstract::Retrograde pyelography to demonstrate the renal pelvis and ureters is a common urologic procedure. Newer contrast materials and better radiographic techniques have obviated many of the previous indications for retrograde studies were independently reviewed by two urologists and a radiologist to determine if the studie...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/0090-4295(79)90196-1

    authors: Taylor RJ,Bennett AH,Schwentker FN,Friedman HW,Geller RA

    更新日期:1979-11-01 00:00:00

  • Papilloma of renal pelvis in childhood.

    abstract::A papilloma in the renal pelvis of a five-year-old girl is reported. The transitional cell tumors of the renal pelvis in the pediatric age group are reviewed, and this is found to be the first case of a benign papilloma in childhood. We believe this pathologic entity should be included in the differential diagnosis of...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/0090-4295(90)80108-y

    authors: Kanamori S,Okumura S,Nishimura T,Hara M,Tsuboi N,Ohba S,Akimoto M,Kawanami O

    更新日期:1990-06-01 00:00:00

  • Seminal plasma biochemical markers and their association with semen analysis findings.

    abstract:OBJECTIVES:To examine the clinical value of six seminal plasma components in the evaluation of sperm quality and in the differential diagnosis of men with infertility. METHODS:We analyzed 202 seminal plasmas for prostate-specific antigen, glucose, pepsinogen C, insulin-like growth factor binding protein-3, prostagland...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/s0090-4295(98)00550-0

    authors: Diamandis EP,Arnett WP,Foussias G,Pappas H,Ghandi S,Melegos DN,Mullen B,Yu H,Srigley J,Jarvi K

    更新日期:1999-03-01 00:00:00

  • Delayed presentation in posterior urethral valve: long-term implications and outcome.

    abstract:OBJECTIVES:To analyze the effect of delayed presentation of posterior urethral valves in children. METHODS:We divided 194 children with posterior urethral valve (PUV) who underwent surgical ablation into group I (less than 2 years old) and group II (greater than 2 years old) according to age at presentation. We analyz...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2007.09.037

    authors: Ansari MS,Singh P,Mandhani A,Dubey D,Srivastava A,Kapoor R,Kumar A

    更新日期:2008-02-01 00:00:00

  • Effect of intravesical instillation on performance of uCYT+ test.

    abstract:OBJECTIVES:To assess the influence of intravesical instillation of epirubicin or bacille Calmette-Guérin (BCG) in patients with bladder cancer on the clinical performance of the uCyt+ test, which traces the three monoclonal antibodies M344, LDQ 10, and 19A211 in urothelial cells. METHODS:A total of 267 patients with a...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2003.12.023

    authors: Lodde M,Mian C,Negri G,Vittadello F,Comploj E,Palermo S,Staffler A,Brössner C,Pycha A

    更新日期:2004-05-01 00:00:00

  • Reconstruction of penile urethra with the 3-dimensional porous bladder acellular matrix in a rabbit model.

    abstract:OBJECTIVE:To evaluate the effect of reconstruction of penile urethra with the 3-dimensional (3-D) porous bladder acellular matrix (BAM) in a rabbit model. MATERIALS AND METHODS:In 30 male rabbits, a ventral urethral mucosal defect (1.5 × 0.8 cm) was created. Substitution urethroplasty was performed with 5% peracetic a...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2014.07.044

    authors: Huang JW,Xie MK,Zhang Y,Wei GJ,Li X,Li HB,Wang JH,Zhu WD,Li C,Xu YM,Song LJ

    更新日期:2014-12-01 00:00:00

  • Morphologic Factors Associated With Open Conversion During Holmium Laser Enucleation of the Prostate.

    abstract:OBJECTIVE:To determine if there is an association between patient body habitus as measured by body mass index (BMI), body surface area (BSA), preoperative prostate volume, postoperative specimen weight, and open conversion with cystotomy or perineal urethrotomy (PU) during holmium laser enucleation of the prostate (HoL...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2020.08.017

    authors: Juvet T,Parikh KA,Ball CT,Dora CD

    更新日期:2020-11-01 00:00:00

  • Transurethral needle ablation for the treatment of chronic pelvic pain syndrome (category III prostatitis): a randomized, sham-controlled study.

    abstract:OBJECTIVES:To investigate the effectiveness and durability of transurethral needle ablation (TUNA) in the treatment of symptoms of chronic pelvic pain syndrome (CPPS) in a randomized, single-blind, sham-controlled study. METHODS:Thirty-three patients with moderate-to-severe symptoms of CPPS were randomized to either T...

    journal_title:Urology

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1016/s0090-4295(02)01704-1

    authors: Leskinen MJ,Kilponen A,Lukkarinen O,Tammela TL

    更新日期:2002-08-01 00:00:00

  • Evaluation of a no-needle penile injector: a preliminary study evaluating tissue penetration and its hemodynamic consequences in the rat.

    abstract:OBJECTIVES:Intracavernous needle injection is an effective delivery method for pharmacotherapy of erectile dysfunction. Needle phobia, pain, and concern about local tissue injury have stimulated the search for new, less invasive means of inducing penile erection. In this preliminary communication, we evaluate a jet inj...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/S0090-4295(97)00541-4

    authors: Seyam RM,Bégin LR,Tu LM,Dion SB,Merlin SL,Brock GB

    更新日期:1997-12-01 00:00:00

  • Reduction of prostate-specific antigen after tamsulosin treatment in patients with elevated prostate-specific antigen and lower urinary tract symptoms associated with low incidence of prostate cancer at biopsy.

    abstract:OBJECTIVES:To evaluate the effect of tamsulosin on reducing the serum levels of prostate-specific antigen (PSA) in patients with lower urinary tract symptoms and an elevated PSA level. METHODS:From June 2004 to July 2006, patients with lower urinary tract symptoms, a PSA level of >or=4 ng/mL, and a maximal flow rate o...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2009.12.083

    authors: Tubaro A,De Nunzio C,Mariani S,Trucchi A,Miano R,Vicentini C,Miano L

    更新日期:2010-08-01 00:00:00

  • Dose response relationship of methotrexate in combination with cisplatin in murine bladder cancer.

    abstract::Methotrexate (MTX) has activity in transitional cell carcinoma (TCC) in man and some have suggested an advantage of high-dose methotrexate versus the standard dose in controlling tumor growth and prolonging survival. MBT-2, a poorly differentiated TCC induced by the carcinogen FANFT, is both grossly and histologically...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/0090-4295(90)80044-n

    authors: Brausi M,Blatnik A,Soloway MS

    更新日期:1990-03-01 00:00:00

  • Radiographic Kinetics of Sarcomatoid Renal Cell Carcinoma.

    abstract::Renal cell carcinoma is a common entity often managed surgically with excellent survival benefits. We report a rare case of sarcomatoid renal cell carcinoma with aggressive growth kinetics after palliative resection captured radiographically. ...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2016.03.027

    authors: Syed A,Raval A,Pridjian A,Birbe R,Trabulsi EJ

    更新日期:2016-07-01 00:00:00

  • Radical retropubic prostatectomy for localized prostate cancer in renal transplant patients.

    abstract:OBJECTIVE:To investigate the feasibility of radical retropubic prostatectomy (RRP) in renal transplant recipients with clinically localized prostate cancer. METHODS:A prospective protocol was established between August 2004 and November 2007. In that period, 8 patients diagnosed with localized prostate cancer were sub...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2008.03.041

    authors: Antonopoulos IM,Nahas WC,Piovesan AC,Falci R Jr,Kanashiro H,Alvarez GA,Srougi M

    更新日期:2008-12-01 00:00:00

  • Mass Forming Eosinophilic Cystitis in Pediatric Patients.

    abstract::Eosinophilic cystitis (EC) is an uncommon inflammatory disorder of uncertain etiology that has been described in adult and pediatric populations. We describe 3 recent cases of EC that presented as a mass lesion in pediatric patients from the New England region of the United States. All patients were initially suspecte...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2016.11.002

    authors: Zhou AG,Amin A,Yates JK,Diamond DA,Tyminski MM,Badway JA,Ellsworth PI,Aidlen JT,Owens CL

    更新日期:2017-03-01 00:00:00

  • Impact of graft position on failure of single-stage bulbar urethroplasties with buccal mucosa graft.

    abstract:OBJECTIVE:To determine whether patency rates after bulbar urethroplasty with buccal mucosa graft onlay differ on the basis of whether the graft is placed ventrally or dorsally. METHODS:This was a retrospective single-center study of all single-stage bulbar urethroplasties performed from 2001 to 2011 by 2 surgeons in w...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2013.07.013

    authors: Figler BD,Malaeb BS,Dy GW,Voelzke BB,Wessells H

    更新日期:2013-11-01 00:00:00

  • Radiologic findings of bilharzial (schistosomal) contracted bladder.

    abstract::The radiologic findings in bilharzial contracted bladder are presented. Calcifications of the bladder were seen in only 4.3 per cent, hydronephrosis in 37.2 per cent, and reflux in 62.8 per cent. ...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/0090-4295(78)90143-7

    authors: Al-Ghorab MM,Rahman MA,El-Rifaie M,Hanafy HM,Abou El Azm T,Arafa A,Saad SM

    更新日期:1978-03-01 00:00:00

  • Microsurgical testis-sparing surgery in small testicular masses: seven years retrospective management and results.

    abstract:OBJECTIVE:To retrospectively evaluate the clinical outcomes of 20 patients diagnosed with a nonpalpable or small testicular mass (2 cm) at 2 academic urological department. Testis-sparing surgery (TSS) is currently performed routinely for the management of nonpalpable testicular masses. High reliability of frozen secti...

    journal_title:Urology

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.urology.2011.12.039

    authors: De Stefani S,Isgrò G,Varca V,Pecchi A,Bianchi G,Carmignani G,Derchi LE,Micali S,Maccio L,Simonato A

    更新日期:2012-04-01 00:00:00

  • Comparison of local anesthesia techniques during transrectal ultrasound-guided biopsies.

    abstract:OBJECTIVES:To compare the effectiveness of periprostatic nerve blockade versus intrarectal lidocaine during transrectal ultrasound-guided biopsies. METHODS:A prospective randomized study was performed on 150 men requiring biopsy of the prostate. Patients were assigned to three groups: group 1 received no anesthetic, g...

    journal_title:Urology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0090-4295(02)01671-0

    authors: Stirling BN,Shockley KF,Carothers GG,Maatman TJ

    更新日期:2002-07-01 00:00:00

  • Functional Restoration of Erectile Function Using End-to-side Autonomic-to-somatic Neurorrhaphy in Rats.

    abstract:OBJECTIVE:To investigate the feasibility of erectile function rehabilitation using end-to-side autonomic-to-somatic neurorrhaphy in rats. MATERIALS AND METHODS:Thirty-six adult male Sprague-Dawley rats were divided into 3 groups (n = 12 per group): in the end-to-side coaptation group, the left L6 and S1 spinal nerves ...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2016.05.017

    authors: Dong C,Dong Z,Xie Z,Zhang L,Xiong F,Wen Q,Fan Z,Peng Q

    更新日期:2016-09-01 00:00:00

  • Urologist attitudes toward end-of-life care.

    abstract:OBJECTIVE:To examine urology trainees' views about the quality and current practices of end-of-life care and to explore strategies for improving integration and quality of care. METHODS:We conducted semi-structured interviews with 20 trainees from 4 institutions in different regions of the United States. Open-ended qu...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2013.01.040

    authors: Bergman J,Lorenz KA,Acquah-Asare S,Scales CD,Ryan G,Saigal CS,Bennett CJ,Litwin MS

    更新日期:2013-07-01 00:00:00

  • Prediction of renal allograft rejection by urinary protein analysis using ProteinChip Arrays (surface-enhanced laser desorption/ionization time-of-flight mass spectrometry).

    abstract:OBJECTIVES:To develop a noninvasive method for the detection of renal transplant rejection using ProteinChip Arrays (surface-enhanced laser desorption/ionization time-of-flight mass spectrometry). METHODS:A total of 23 urine samples were collected from 13 patients showing biopsy-proven renal allograft rejection and fr...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2005.09.038

    authors: Reichelt O,Müller J,von Eggeling F,Driesch D,Wunderlich H,Schubert J,Gröne HJ,Stein G,Ott U,Junker K

    更新日期:2006-03-01 00:00:00

  • Alpha1-adrenoceptor signaling in the human prostate involves regulation of p38 mitogen-activated protein kinase.

    abstract:OBJECTIVE:To investigate whether 1-adrenoceptor signaling in the human prostate involves regulation of the mitogen-activated protein kinase (MAPK) p38. Although α1-adrenoceptors are an important target for therapy of lower urinary tract symptoms in patients with prostate hyperplasia, intracellular signaling by prostate...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2011.03.036

    authors: Strittmatter F,Gratzke C,Walther S,Göttinger J,Beckmann C,Roosen A,Schlenker B,Reich O,Stief CG,Hennenberg M

    更新日期:2011-10-01 00:00:00

  • Milk of calcium in abdomen.

    abstract::A 45-year-old woman had an asymptomatic abnormality on a screening abdominal radiograph. The radiopaque mass in her right upper abdomen was surrounded by numerous "pearls" and resembled an abalone on the supine abdominal radiograph. We advised an additional upright abdominal radiograph, which showed a calcium fluid le...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/j.urology.2010.03.056

    authors: Huang YS,Huang KH,Chang CC,Liu KL

    更新日期:2011-03-01 00:00:00

  • Extraperitoneal Uterosacral Ligament Hysteropexy: A Novel Treatment for Apical Compartment Prolapse.

    abstract:OBJECTIVE:To treat mild-to-moderate apical compartment prolapse while preserving the uterus, our extraperitoneal uterosacral ligament hysteropexy repair technique was developed. Hysterectomy for prolapse accounted for 13% of all benign hysterectomies, which is the third most common reason.1 Although concomitant hystere...

    journal_title:Urology

    pub_type:

    doi:10.1016/j.urology.2020.02.026

    authors: Ossin D,Ramirez-Caban L,Hurtado E

    更新日期:2020-06-01 00:00:00

  • Methylmethacrylate upper ureteral obstruction.

    abstract::A case of upper ureteral obstruction caused by methylmethacrylate cement after fixation of an L2-L3 vertebral fracture is reported. The probable mechanism, radiographic findings, and management of this complication are reviewed. ...

    journal_title:Urology

    pub_type: 杂志文章

    doi:10.1016/0090-4295(86)90414-0

    authors: Fiore A,Addonizio JC,Katz S,Choudhury M

    更新日期:1986-05-01 00:00:00

  • Integrated analysis examining first-dose success, success by dose, and maintenance of success among men taking tadalafil for erectile dysfunction.

    abstract:OBJECTIVES:To examine, in a post-hoc, integrated analysis, the first-dose success, cumulative success by dose, and maintenance of success among men taking tadalafil. Early treatment success is important to men with erectile dysfunction. METHODS:In five double-blind, placebo-controlled, 12-week studies, men were random...

    journal_title:Urology

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1016/j.urology.2004.05.046

    authors: Schulman CC,Shen W,Stothard DR,Schmitt H

    更新日期:2004-10-01 00:00:00