Pain intensity after robotic-assisted urological surgery: the PAIROU study an international prospective cohort study - 06/06/25
Doi : 10.1016/j.accpm.2025.101546
Pauline Rouxel a, Emilien Rayon b, Anne-Sophie Bellocq c, Morgan le Guen d, Julien Fessler d, Cédric Cirenei e, Raïko Blondonnet f, Emmanuel Parfait g, Ana-Gabriela Patrubani h, Andersen Ramorasata i, Aurélie Gouel j, Nicolas Brogly k, Guillaume Devoldere l, Mélanie Dupont m, Elodie Gaultier m, Martin Dupuis n, Pierre Bouzat n, Mathilde Cattenoz o, Sophie Prieur p, Philippe Cuvillon q, Yann Gricourt q, Bruno Pastene r, Pierre Huette s, Matthias Garot t, Andry Ramarosaona t, Rémi Massin t, Guillaume Grailles u, Amélie Rollé v, Ibrahim Moussa Daouda v, Romain Boinette w, Julien Birckener x, Pierre Habrial y, Toufik Samaha z, Adrien Lemoine A, Alexandre Damon B, Marie Rodriguez C, Thierry Braun D, Marine Fritsch E, Sahfouane Tawil F, Vincent Guerin F, Laure Lagrave-Blampied G, Céline Ravry H, Michael Poette I, Stéphanie Tao-Mauny J, Willy-Serge Mfam J, Matthieu Fontaine K, Mehrez Boutouria L, Nordine Deffar M, Florent Sigwalt N, Laurent Thiltges O, Mirela Ionescu P, Maria Victoria Acedo Diaz-Pache Q, Rosalia Navarro Perez Q, Gianluca Caragliano R, Louis Profumo S, Benoit Peyronnet T, Alain Renault U, Alexandre Joosten V, Helene Beloeil W, ⁎ 
the PAIROU group and French Society of Anesthesiologists (SFAR) Research Network
a CHU Rennes, University Rennes, IRSET, UMR_S 1085, INSERM CIC 1414, Anaesthesia and Intensive Care Department, 35000 Rennes, France
b CHU Rennes, Anesthesia and Intensive Care Department, F-35000 Rennes, France
c Service D’Anesthésie-Réanimation, CHU de Lyon, Hôpital Edouard Herriot, 5 Pl. d'Arsonval, 69003 Lyon, France
d Département d'Anesthésie-Algologie, Hôpital Foch, Université Versailles Saint Quentin, Suresnes, France
e Department of Anesthesia and Intensive Care, CHU de Lille, Univ Lille, ULR 2694 - Metrics, F-59000 Lille, France
f Department of Anesthesia, Intensive Care Unit and Perioperative Medicine, Private Hospital La Chataigneraie, Beaumont, France
g Department of Anesthesia, Intensive Care Unit and Perioperative Medicine, Hôtel-Dieu, CHU de Nantes, 1 place Alexis Ricordeau - 44093, Nantes, France
h Department of Anesthesia, CHU Saint-Pierre, 322 rue Haute, 1000 Bruxelles, Belgium
i Department of Anesthesia, Centre Hospitalier Intercommunal de Mont-de-Marsan et du Pays des Sources, 417 Av. Pierre de Coubertin BP, 40024 Mont-de-Marsan, France
j Anaesthesiology and Critical Care Medicine Department, DMU PARABOL, Bichat Hospital, AP-HP, Institut Pasteur, INSERM UMR1222, Paris City University, Paris, France
k Department of Anesthesia, Intensive Care Unit and Perioperative Medicine, Hospital Universitario La Zarzuela, Madrid, Spain
l Department of Anesthesiology, Catholic University Hospital / Catholic School of Medicine, Lille Catholic University, Lille, France
m Department of Anesthesia, Intensive Care Unit and Perioperative Medicine, AP-HP Nord, DMU PARABOL, Hôpital Saint-Louis, Paris, France
n Grenoble Alps University, Anaesthesiology and Intensive Care Unit, Grenoble University Hospital, 38000 Grenoble, France
o Department of Anesthesia, CH Bourg en Bresse, 900 Rte de Paris, 01012 Bourg-en-Bresse, France
p Department of Anesthesia, Intensive Care Unit and Perioperative Medicine, Centre Hospitalier Intercommunal Toulon-La Seyne sur mer, 54 Rue Henri Sainte-Claire Deville, 83100 Toulon, France
q Department of Anesthesia, Intensive Care Unit and Perioperative Medicine, Pole ARDU CHU Caremeau, Nimes, France
r Department of Anesthesia, Intensive Care Unit and Perioperative Medicine – Hôpital Nord – Assistance Publique Hôpitaux de Marseille, Aix Marseille Univ, INSERM, INREA, C2VN – Marseille, France
s Department of Anesthesiology, Clinique Victor Pauchet, 80000 Amiens, France
t Department of Anesthesiology, Hôpital Privé Arras les Bonnettes, 2 Rue du Dr Forgeois, 62000 Arras, France
u Department of Anesthesiology, CH Valenciennes, France
v Université des Antilles, CHU de la Guadeloupe, INSERM, BIGR, Anesthesia and Intensive Care Departement, 97139 Guadeloupe, France
w SVAR Anesthesie-Réanimation, Clinique Saint Vincent, 25000 Besançon, France
x Department of Anesthesia, Intensive Care Unit and Perioperative Medicine, CHRU de Nancy - Hôpitaux de Brabois Adulte, 54500 Vandœuvre-Lès-Nancy, France
y Département d’Anesthésie-Réanimation, Clinique de l’Anjou, Angers, 9 Rue de l'Hirondelle, 49044 Angers, France
z Department of Anesthesia, Intensive Care Unit and Perioperative Medicine, CH de Sens, 1 Av. Pierre de Coubertin, 89100 Sens, France
A Department of Anesthesia, Intensive Care Unit and Perioperative Medicine, Hôpital Tenon, APHP - Sorbonne Université, Paris, France
B Department of Anesthesia, Intensive Care Unit and Perioperative Medicine CH Brive, Centre Hospitalier Dubois - Brive la Gaillarde, 1 Bd Dr Verlhac, 19100 Brive-la-Gaillarde, France
C Department of Anesthesia, Intensive Care Unit and Perioperative Medicine, Hopital de la Pitie-Salpetriere, APHP, Université Paris Sorbonne, Paris, France
D Department of Anesthesia, Intensive Care Unit and Perioperative Medicine, Clinique Sainte-Anne, 182 rte de la Wantzenau, 67000 Strasbourg, France
E Department of Anesthesia, Intensive Care Unit and Perioperative Medicine, CHU Strasbourg, 1 place de l’Hôpital, 67000 Strasbourg, France
F Department of Anesthesia, Intensive Care Unit and Perioperative Medicine, Assistance Publique Hôpitaux de Marseille - Hôpital la Conception, 147 Bd Baille, 13005 Marseille, France
G Department of Anesthesia, Intensive Care Unit and Perioperative Medicine, CHU de Rouen, 37 Bd Gambetta, 76000 Rouen, France
H Department of Anesthesia, Centre Hospitalier de Dax – Côte d’Argent, Bd Yves du Manoir, 40100 Dax, France
I Toulouse University Hospital, Anaesthesia Critical Care and Perioperative Medicine Department, Toulouse, France
J Department of Anesthesia, Intensive Care Unit and Perioperative Medicine, CHU Orléans, 14 av de l'hôpital, 45067 Orléans, France
K Department of Anesthesia, Intensive Care Unit and Perioperative Medicine, Hôpital Saint Joseph Saint Luc, 20 Quai Claude Bernard, 69007 Lyon, France
L Department of Anesthesia, Intensive Care Unit and Perioperative Medicine, Polyclinique sainte marguerite 5 av de la fontaine saint marguerite, 89000 Auxerre, France
M Department of Urology, Institut d’Urologie d’Auxerre, Polyclinique Sainte Marguerite, 5 avenue de la Fontaine Sainte Marguerite, 89000 Auxerre, France
N Hôpital Privé Jean Mermoz, Groupe d'anesthésie SDF MORPHEE 55 Av. Jean Mermoz, 69008 Lyon, France
O Department of Anesthesia, Intensive Care Unit and Perioperative Medicine, CHU La Reunion, Site Nord Allée des Topazes CS 11 021, 97400 Saint-Denis, France
P Department of Anesthesia Intensive Care Unit and Perioperative Medicine CH Saintonge, 11 Bd Ambroise Paré, 17100 Saintes, France
Q Department of Anesthesia, Complutense University of Madrid, Clinico San Carlos. Madrid, Spain
R Department of Anesthesia, Centre Clinical - Soyaux, Angoulême, 2 Chem. de Fregeneuil, 16800 Soyaux, France
S Department of Anesthesia Intensive Care Unit and Perioperative Medicine, Clinique Rhéna,10 Rue François Epailly, 67000 Strasbourg, France
T Department of Urology, University of Rennes, NUMECAN Research Unit, Rennes, France
U Univ Rennes, Inserm, CIC 1414 (Clinical Investigation Center), F-35000 Rennes, France
V Departement of Anesthesiology, Université Paris-Saclay, Hôpital Bicetre, Assistance Publique Hôpitaux de Paris, Le Kremlin Bicetre, France and Department of Anesthesiology & Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, California, United States of America
W CHU Rennes, Univ Rennes, Inserm, OSS 1242, CIC 1414, Anesthesia and Intensive Care Department, F-35000 Rennes, France
⁎Corresponding author.
Abstract |
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.
Le texte complet de cet article est disponible en PDF.Keywords : Postoperative pain, Postoperative analgesia, Robotic-assisted urological surgery
Plan
© 2025
Publié par Elsevier Masson SAS.
Vol 44 - N° 4
Article 101546- août 2025 Retour au numéro
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