LAUSR

OBJECTIVES To prospectively compare robotically administered transperitoneal transversus abdominis plane to ultrasound-guided TAP (UTAP) to local anesthesia (LA) for pain control and narcotic use in robotic prostatectomy (RP) and robotic partial nephrectomy (RPN) patients. SUBJECTS/PATIENTS AND METHODS Patients undergoing RP or RPN were randomized in a single blind 2:2:1 fashion to RTAP:UTAP:LA, with the study powered to evaluate superiority of UTAP to LA and non-inferiority of RTAP to UTAP. We compared time to deliver the block, operating room time, postoperative pain scores using the visual analog scale (VAS), and intraoperative and postoperative analgesia consumption. RESULTS 143 patients were randomized and received a treatment. There was no significant difference in patient baseline characteristics. UTAP did not demonstrate superiority to LA in terms of pain control. RTAP and LA were faster than UTAP (time to perform block 2.5 vs. 2.5 vs. 6.25 min, p<.001). There was no difference in postoperative narcotic, acetaminophen, ketorolac, or ondansetron requirements among all three groups (p>0.05). The study was terminated early due to the unexpected efficacy of LA. CONCLUSION UTAP and RTAP do not provide superior pain control to LA. LA's efficiency, effectiveness, and ease of administration make it a first line therapy for postoperative analgesia.