Roseanne Ferreira¹, Kevin C. Zorn², Naeem Bhojani², Bilal Chughtai³, Dean S. Elterman⁴

Canadian Journal of Urology, Vol.30, No.1, pp. 11448-11452, 2023

Abstract Penthrox is a portable handheld inhaler that delivers a low dose of methoxyflurane - an anesthetic with analgesic effects, rapid onset of action, and a favorable side-effect profile. It has been widely used for acute pain management in Australia for the past 40 years. Currently, it is approved for use in over 55 countries, including Canada. Prospective randomized studies highlight Penthrox analgesic effectiveness and safety profile for emergency, prehospital and outpatient settings. In addition, the use of multimodal analgesia, specifically Penthrox, can play an important role in the analgesic management of urological procedures, such as More >

Jacob R. Stephens¹, Kenneth M. Peters^1,2

Canadian Journal of Urology, Vol.29, No.1, pp. 11032-11035, 2022

Abstract Vulvodynia is a debilitating disorder which can prove extremely difficult to treat. Neuromodulation is increasingly becoming a frontline therapy in various chronic pain syndromes. We present a relatively simple surgical technique utilizing targeted neuromodulation leading to the successful treatment of vulvodynia. More >

Dean S. Elterman¹, Kevin C. Zorn², Naeem Bhojani², Bilal Chughtai³

Canadian Journal of Urology, Vol.29, No.6, pp. 11355-11360, 2022

Abstract Introduction: The safety and efficacy of low dose methoxyflurane disposable inhaler (Penthrox) was assessed in this study of men undergoing Rezum water vapor thermal therapy (WVTT).
Material and methods: An open-labeled, single-center study was conducted to demonstrate the safety and efficacy of using methoxyflurane inhaler during a Rezum procedure. Patients assessed current pain intensity using a 10-point Visual Analog Scale (VAS) of Pain at 4 timepoints including (1) before any medication, (2) initially after insertion of the rigid cystoscope and before any Rezum treatment, (3) immediately after final injection of Rezum treatment and (4) at discharge. Patients… More >

Austin J. Lee¹, Jonathan G. Yabes², Nathan Hale³, Ronald L. Hrebinko³, Jeffrey R. Gingrich³, Jodi K. Maranchie³, Mina M. Fam³, Robert M. Turner II³, Benjamin J. Davies³, Bruce Ben-David⁴, Bruce L. Jacobs³

Canadian Journal of Urology, Vol.25, No.2, pp. 9255-9261, 2018

Abstract Introduction: Multimodal analgesia is an effective strategy for managing postoperative pain and reducing opioid dependence. The quadratus lumborum block (QLB) and paravertebral block (PVB) are two regional anesthesia techniques that enhance multimodal pain management. In this study, we aimed to compare the efficacy of these two approaches in patients undergoing radical cystectomy. Materials and methods: A retrospective review was conducted on patients who underwent radical cystectomy between 2014 and 2016. Patients were divided into two groups based on the type of regional anesthesia received: bilateral continuous paravertebral blocks (n = 125) or bilateral single-shot quadratus lumborum blocks… More >

Stephen Lukasewycz¹, Matt Holman², Paul Kozlowski¹, Christopher R. Porter¹, Erin Odom¹, Chris Bernards², Nancy Neil³, John M. Corman¹

Canadian Journal of Urology, Vol.17, No.5, pp. 5377-5382, 2010

Abstract Introduction: Robotic assisted laparoscopic radical prostatectomy (RALP) is a common treatment for localized prostate cancer. Despite a primary advantage of improved postoperative pain, patients undergoing RALP still experience discomfort. Belladonna, containing the muscarinic receptor antagonists atropine and scopolamine, in combination with opium as a rectal suppository (B & O) may improve post-RALP pain. This study evaluates whether a single preoperative B & O results in decreased postoperative patient-reported pain and analgesic requirements.
Materials and methods: Patients undergoing RALP at Virginia Mason Medical Center between November 2008 and July 2009 were offered the opportunity to enter a randomized,… More >

Paul Toren¹, Salima Ladak², Clement Ma^{3, Stuart McCluskey2, Neil Fleshner1}

Canadian Journal of Urology, Vol.16, No.4, pp. 4716-4720, 2009

Abstract Objective: Postoperative analgesia is an important factor influencing surgical outcomes. We aimed to evaluate the role of patient controlled epidural analgesia (PCEA) versus intravenous (IV) patient controlled analgesia (PCA) in patients undergoing radical cystectomy.
Methods: We reviewed data from consecutive patients who had a radical cystectomy at our institution between 2003 and 2007 to evaluate the effect of either PCEA or IV PCA on the patients' postoperative pain--the primary outcome--as well as secondary outcomes including time to begin eating solid food, time to ambulation, and length of hospital stay. The patients received either hydromorphone or morphine via… More >

R. Ashley McLellan¹, David G. Bell^1,2, Ricardo A. Rendon^1,2

Canadian Journal of Urology, Vol.13, No.5, pp. 3244-3249, 2006

Abstract Objectives: To assess the impact of a clinical pathway (CP) on length of stay (LOS), complications, readmission rates, and patient satisfaction for patients undergoing a radical retropubic prostatectomy (RRP).
Materials and methods: A standardized CP for all patients undergoing RRP was developed and implemented. Post-operatively, patients enrolled in the CP received oral ibuprofen and acetaminophen analgesia, with oral and subcutaneous narcotics available for breakthrough pain. Patients enrolled in the CP were compared to a pre-CP historical cohort. Patients were asked to complete a short, validated satisfaction questionnaire 10 days post-operatively.
Results: Sixty-eight consecutive patients underwent a RRP More >