Mp08-10 Regional and Epidural Anesthesia Increases Length of Stay in After Radical Cystectomy

You have accessJournal of UrologyBladder Cancer: Epidemiology & Evaluation I (MP08)1 May 2024MP08-10 REGIONAL AND EPIDURAL ANESTHESIA INCREASES LENGTH OF STAY IN AFTER RADICAL CYSTECTOMY Young Son, Jacob Thatcher, Katelyn Klimowich, Julia Scali, Benjamin Fink, Lance Earnshaw, Edward Wu, Thomas Mueller, and Gordon Brown Young SonYoung Son , Jacob ThatcherJacob Thatcher , Katelyn KlimowichKatelyn Klimowich , Julia ScaliJulia Scali , Benjamin FinkBenjamin Fink , Lance EarnshawLance Earnshaw , Edward WuEdward Wu , Thomas MuellerThomas Mueller , and Gordon BrownGordon Brown View All Author Informationhttps://doi.org/10.1097/01.JU.0001008780.87855.57.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical cystectomy (RC) is a treatment option for muscle invasive bladder cancer or those with high-risk non-muscle invasive bladder cancer. Length of stay (LOS) has been an important metric in quality of life and implementation of ERAS protocols have attempted to curtail the LOS. Pain is a key factor in a prolonged LOS especially within the first few days post operatively. The aim of this study is to determine if additional anesthesia techniques can reduce LOS. METHODS: A retrospective review was performed using the National Surgical Quality Improvement Project (NSQIP) database in 2019 and 2020 for patients undergoing RC for malignant etiologies. Additional anesthesia techniques were subdivided into epidural, regional, and local blocks. Patients were excluded if more than one additional anesthesia techniques were used. The three groups were then compared with pre, peri, and postoperative variables. Descriptive analysis and a multivariate linear regression were performed to determine the association with LOS. RESULTS: A total of 1866 patients were included in the analysis. Of the total cohort, epidural was seen to be used in 50.2%, regional in 29.4%, and local in 20.5%. There was no difference in age, gender, or BMI within the cohort. The length of stay was greatest in the epidural group at 8.1 days compared to 7.4 days of regional and 6.7 days in the local group (p<0.001) (Figure 1). In the adjusted analysis, regional (p=0.042) and epidural (p=0.019) was found to have longer LOS compared to local. Additionally, prolonged NPO, pneumonia, organ space SSI, and urinary leak were independent predictors of increased LOS (Figure 2). CONCLUSIONS: Increased LOS after radical cystectomy can increase infection risk and decrease quality of life. Pain control during and after RC is crucial for recovery, however we show that additional anesthesia techniques including regional and epidural blocks have longer length of stay compared to local blocks alone. Caution should be used for surgeons utilizing additional anesthesia techniques to ensure optimized post operative course. Download PPTDownload PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e118 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Young Son More articles by this author Jacob Thatcher More articles by this author Katelyn Klimowich More articles by this author Julia Scali More articles by this author Benjamin Fink More articles by this author Lance Earnshaw More articles by this author Edward Wu More articles by this author Thomas Mueller More articles by this author Gordon Brown More articles by this author Expand All Advertisement PDF downloadLoading ...