Analgesic and antiemetic requirements after minimally invasive surgery for early cervical cancer: A comparison between laparoscopy and robotic surgery

Background: Women with early cervical cancer undergoing radical hysterectomy via minimally invasive surgery (MIS) have decreased blood loss and a shorter hospital stay compared with laparotomy. It remains unclear whether there is a difference in benefit to the patient between robotic surgery and traditional laparoscopy. We sought to compare postoperative analgesic and antiemetic requirements between the two approaches. Methods: After institutional review board approval, the medication administration records of all patients who underwent MIS radical hysterectomy for cervical cancer at MD Anderson Cancer Center were reviewed. Analgesic and antiemetic medication use as well as visual pain scores was recorded. Descriptive statistics and nonparametric tests were used to compare the groups undergoing laparoscopy (LRH) and robotic surgery (RRH). Results: A total of 85 patients underwent MIS for early cervical cancer, 55 LRH and 30 RRH. Median age was older in the RRH (42 vs. 52 years, p = 0.001). There was no difference in median body mass index (26.9 vs. 26.8 kg/m ², p = 0.71). Length of stay was significantly shorter in the RRH (2 vs. 1 day, p = 0.005). Total intravenous opioids administered were significantly higher in the LRH (26.7 mg morphine equivalents) compared with the RRH (10.7 mg morphine equivalents) (p = 0.001). There was no difference in visual pain scores or antiemetics given. Conclusions: Intravenous opioids administered were significantly less for RRH compared to LRH; however, there was no difference in visual pain scores. Prospective studies are being performed to evaluate quality of life in patients undergoing MIS for gynecologic cancers.