The Effects of Method of Anaesthesia on the Safety and Effectiveness of Radical Retropubic Prostatectomy

Measurement of patients systolic and diastolic blood pressure during the operation and post-operatively for 72 hours.

Measurement of patients Heart Rate during the operation and post-operatively for 72 hours.

Calculation of the Surgical APGAR score for each patient during surgery. The lower the score, on a scale of 1-10, the worst the prognosis of the patient.

SAS is calculated using three variables:

• Estimated blood loss (on a 0-3 scale, 0 points >1000 ml, 1 point 601-1000ml, 2 points 101-600 ml, 3 points <100ml)
• Lowest mean arterial pressure (on a 0-3 scale, 0 points <40 mmHg, 1 point 40-54 mmHg, 2 points 55-69 mmHg, 3 points >70 mmHg)
• Lowest heart rate (on a 0-4 scale, 0 points >85 bpm, 1 points 76-85 bpm, 2 points 66-75 bmp, 3 points 56-65 bmp, 4 points <55 bmp) during surgery.

Measured from suction contents intra-operatively in ml

Haemoglobin measurement before the operation and at 12-, 24- and 48-hours post-operatively, in g/dL

Time required for:

• Induction of anaesthesia
• Completion of the operation
• Post-operative time until the patient is successfully transferred to the recovery room

Measured using a pain Visual Analogue Scale (VAS) at 6-, 24- and 48-hours after the operation.

VAS is a self-reporting pain scale based on a 0 to 10-point system, with each point measuring 10mm on a linear line. Every patient was asked to indicate his pain levels from "No Pain" (equals 0) to "Worst Pain Imaginable" (equals 10).

Complications related to the procedure:

• Intraoperative bleeding
• Post-operative bleeding
• Bowel perforation
• Cardiovascular
• Respiratory

Complications related to the anaesthesia technique performed:

• Post-operative headache
• Nausea and vomiting
• Any signs of potential nerve damage (manifested as inability to gain leg motility)

Measurement of Prostatic Specific Antigen (PSA) levels at 6 to establish a PSA nadir value

Measurement of Prostatic Specific Antigen (PSA) levels at 12 post-operation to detect any biochemical recurrence

Measured using the International Index of Erectile Function (IIEF-5) questionnaires pre-operatively and at 3-, 6- and 12-months post-surgery.

The test is composed of 5 questions with 5 points for each question. Patients are evaluated accordingly:

• Score 22 or more = No Erectile Disfunction
• Score 17-21 = Mild Erectile Disfunction
• Score 12-16 = Mild to moderate Erectile Disfunction
• Score 8-11 = Moderate Erectile Disfunction
• Score 7 or less = Severe Erectile Disfunction

Results will be:

• Analysed and compared to evaluate any potential difference of the two methods of anaesthesia, on post-operational erectile function
• Analysed comparing pre-operation with post-operation questioners overall, to evaluate erectile disfunction after radical prostatectomy regardless of method of anaesthesia.

Measured using the International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form at 12 months post-surgery.

The Questionnaire is consisted of 4 questions:

• Frequency "How often do you leak urine?" on a scale of 0 (never) to 5 (all the time)
• Amount of leakage "How much urine do you leak?" on a scale to 0 (none) to 3 (a large amount)
• Overall impact on quality of life "How much does it interfere with your life?" on a scale of 0 (not at all) to 10 (a great deal)
• Timing of leakage "When does urine leak?"

Days until patient discharge from the hospital.

Satisfaction, using the Short Assessment of Patient Satisfaction (SAPS) Questionnaire, is measured in a scale of 0 to 28, with 0 to 10 equals to "Very Dissatisfied", 11-18 equals to "Dissatisfied", 19-26 equals to "Satisfied" and 27-28 equals to "Very Satisfied"