title: The Impact of Robotic Versus Conventional Coronary Artery Bypass Grafting on In-Hospital Narcotic Use: A Propensity-Matched Analysis.
abstract: OBJECTIVE
  The aim of this study was to compare narcotic use in the perioperative hospital stay as a measure of pain in patients undergoing robotic versus conventional coronary artery bypass grafting (CABG).
  
  
  METHODS
  Propensity score matching of patients undergoing robotically assisted CABG and conventional CABG over a period of 5 years was performed. A retrospective chart review was performed to identify the total amount of narcotics used by both groups calculated as morphine equivalent dosing (MED).
  
  
  RESULTS
  From 2007 to 2012, 154 patients underwent robotic CABG, and 1660 underwent conventional CABG. Propensity matching resulted in 142 patients in each group. Patients undergoing robotic CABG received less blood transfusion, were more frequently extubated in the operating room, and had a shorter length of stay. The robotic group had a lower MED than the conventional group as defined by the primary end point [181 (11) vs 251 (8)]. If intraoperative narcotic use was eliminated, there was no difference in MED from postoperative days 0 to 3.
  
  
  CONCLUSIONS
  Patients undergoing robotic CABG use fewer narcotics over the first three hospital days than patients undergoing conventional CABG. The surrogate of narcotics use for postoperative pain shows that the minithoracotomy of robotic CABG may result in either less or equivalent pain than the sternotomy of conventional CABG.
authors.affiliation: From the *Albert Einstein College of Medicine and Einstein-Montefiore Medical Center, Bronx, NY USA; and †Icahn School of Medicine at Mount Sinai and The Mount Sinai Health System, New York, NY USA.
authors.forename: Wissam N
authors.initials: WN
authors.lastname: Raad
authors.forename: Stephen
authors.initials: S
authors.lastname: Forest
authors.forename: Marco
authors.initials: M
authors.lastname: Follis
authors.forename: Patricia
authors.initials: P
authors.lastname: Friedmann
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: DeRose
mesh_terms: D000368:Aged; D001803:Blood Transfusion; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage*; D059035:Perioperative Period; D057216:Propensity Score; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D013908:Thoracotomy / Q000379:methods; D016896:Treatment Outcome
chemical_list: D009294:Narcotics