The effect of intraperitoneal ropivacaine on pain after laparoscopic colectomy: a prospective randomized controlled trial.
Author(s): Park YH, Kang H, Woo YC, Park SG, Baek CW, Jung YH, Kim JY, Koo GH, Kim SD, Park JS
Affiliation(s): Department of Anaesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.
Publication date & source: 2011-11, J Surg Res., 171(1):94-100. Epub 2010 Apr 8.
Publication type: Research Support, Non-U.S. Gov't
BACKGROUND: Although laparoscopic procedures are becoming more common, postoperative pain remains a major factor causing delayed patient recovery. There have been several trials to reduce pain by instilling local anesthetics into the peritoneal cavity, but there has been no study on prolonged ( approximately 300 min) or intensive surgery. We investigated the analgesic effect of intraperitoneal ropivacaine instillation after laparoscopic colectomy. MATERIALS AND METHODS: Sixty patients were randomized to three groups. Twenty patients in each group received 50 mL of appropriate solutions after the formation of a pneumoperitoneum. The solution was normal saline (control) in group C and 1 mg/kg of ropivacaine in each of groups I and D. In group D, ropivacaine was sprayed again before the elimination of the pneumoperitoneum. Patients reported their postoperative pain using a subjective visual analogue scale. Fentanyl use for pain relief and frequency of pushing a button (FPB) for a bolus of patient controlled analgesia were evaluated, and scales of recovery rates were obtained. RESULTS: The immediate postoperative pain score was lower in groups I and D than in group C. In groups I and D, FPB measures and fentanyl use were both less than in group C. The time taken to resume a regular diet was shorter in group D than in group C. CONCLUSIONS: The intraperitoneal instillation of ropivacaine was effective in reducing postoperative pain and in shortening the recovery course after laparoscopic colectomy. The additional instillation of ropivacaine at the end of the surgery proved even more effective. Crown Copyright (c) 2011. Published by Elsevier Inc. All rights reserved.