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Objectives: Radical prostatectomy is followed by postoperative pain, that can be linked to potential morbidity. Aim of this study is to compare efficacy of epidural infusion of ropivacaine and fentanyl versus intravenous administration of morphine in terms of reduction of pain and possible complications., Materials and Methods: We have considered 73 consecutive patients who underwent a retropubic radical prostatectomy. For analgesia control we have considered the use of epidural infusion of ropivacaine and fentanyl (Group R) in 48 patients, compared to continuous intravenous administration of morphine (Group M) in 25 patients. Evaluation criteria have been: blood pressure, heart and breath rate, sedation state, nausea and vomit, entity of pain with VRS scale (Verbal Rating Score) at rest and in movement in the first 72 hours, canalization and need of additional analgesia., Results: VRS values were lower in Group R especially during movement, and need of additional analgesia was reported in one patient of Group R, and in three patients of Group M; assumption of morphine was interrupted in three patients. Epidural catheter was removed for malfunction in three patients, and seven patients complained for leg paresthesia., Conclusion: Sedation resulted higher in group M. Mobilization in second day occurred with fewer difficulties for patients of group R, while canalization resulted delayed in group M. Results underlined a good analgesic cover in both groups. Advantages of epidural analgesia are represented by the use of smaller doses of opioids, fewer cardiocirculatory and respiratory side effects, lower incidence of nausea and vomit, early canalization and post-operative mobilization.

Background: Although laparoscopic cholecystectomy (LC) results in less pain then open cholecystectomy, it is not a pain-free procedure. The aim of this study was to test a new method of preemptive analgesia.Methods: By simple randomization 60 patients were assigned to two groups (30 in each group). Group A, the placebo group, received 200 ml of 0.9% saline, and group B received 5 mg/kg of a local anesthetic solution (ropivacaine) in 200 ml of 0.9% saline. Local anesthetic or placebo solution were administer before creation of the pneumoperitoneum.Results: Pain intensity, as rated by visual analog and verbal rating scales, and stress response data were significantly less in the group receiving ropivacaine than in the placebo group. No patients in treatment group received an additional dose of analgesic, whereas two patients in placebo group needed an additional analgesic.Conclusions: Our results support the clinical validity of preemptive analgesia, but the timing of intraperitoneal administration of local anesthetic is very important. Only application before creation of the pneumoperitoneum may preempt every neuronal central sensitization. [ABSTRACT FROM AUTHOR]