Robot Assisted Laparoscopic Radical Prostatectomy- RALP

These patients are positioned in a steep Trendelenburg position. A non-slip gel and shoulder bolsters help prevent slipping.

Pre-op

• Discuss
  • Spinal
  • GA
  • Facial swelling from steep Trendelenberg
• PO paracetamol

Peri-op

• 16G cannula in non dominant hand
• Art line only for patient factors
• Spinal – 1.5ml 0.5% heavy 0.5% L-bupivicaine + 700mcg diamorphine (total 2.2ml)
• Prop + remi TCI
• ETT – ensure tie isn’t too tight to allow for swelling
• Anti-emetics
  • Dexamethasone 6.6mg
  • Ondansetron 4mg
• Analgesia
  • Paracetamol 1g
  • Oxycodone 5mg
  • Magnesium

Post-op

• Regular paracetamol
• PRN oramorph
• PRN anti-emetics
• PRN laxatives

Twists

• No spinal
  • In that case: oxycodone 10mg, clonidine, hyoscine butylbromide (buscopan), 0.3mg/kg ketamine