Comparison of Spinal Morphine and Intravenous Lidocaine for Recovery After Robotic Upper Urinary Tract Surgery

What this Trial Is About

Researchers are investigating whether adding spinal analgesia improves recovery for patients undergoing robotic-assisted laparoscopic upper urinary tract surgery under general anesthesia. This study aims to compare the effects of spinal analgesia with morphine and bupivacaine to an intravenous lidocaine infusion during surgery. It evaluates recovery using the Quality of Recovery 15 QoR-15 scale and examines pain, nausea, opioid use, time out-of-bed, length of hospital stay, and complications, along with monitoring potential side effects like hypotension and cardiac dysfunction. Participants are randomly assigned to receive either a single shot spinal analgesia before surgery with morphine and bupivacaine or an intravenous lidocaine infusion during surgery. The spinal analgesia involves a one-time injection before surgery, while the lidocaine is given continuously during the operation. A subgroup of patients will have advanced heart function measurements and blood samples taken before, during, and after surgery to analyze inflammation and cardiac issues. Throughout the study, recovery will be assessed through interviews using the QoR-15 scale before surgery, on the first day after surgery, and on the seventh day. Patients will also keep a diary recording pain levels at rest and during movement three times daily. Researchers will track many outcomes including pain, nausea, opioid use, time spent out of bed, length of stay, and complications up to 30 days after surgery. Safety monitoring includes heart and blood pressure measurements during surgery, and blood tests for inflammation and heart function after surgery.

Spinal Morphine or Intravenous Lidocaine in Robot-assisted Upper Urologic Surgery