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Postoperative pain relief using intermittent injections of 0.5% ropivacaine through a catheter after laparoscopic cholecystectomy.
- Source :
-
Anesthesia and analgesia [Anesth Analg] 2002 Aug; Vol. 95 (2), pp. 450-6, table of contents. - Publication Year :
- 2002
-
Abstract
- Unlabelled: Postoperative pain has been an important limiting factor for ambulatory laparoscopic cholecystectomy. We anesthetized 40 ASA physical status I-II patients using propofol for the induction and sevoflurane in oxygen and air for the maintenance of anesthesia. At the end of the anesthesia, the patients were randomized into one of two groups: Group P (Placebo) and Group R (0.5% Ropivacaine). Twenty milliliters of normal saline or ropivacaine, respectively, were injected intraperitoneally at the end of surgery via a catheter placed in the bed of the gall bladder. Postoperatively, intermittent injections (10 mL) of the study solution were given when required for pain. Ketobemidone 1-2 mg was given IV as rescue medication. Pain was assessed using a visual analog scale at 1, 2, 3, 4, 8, 12, 16, and 20 h after surgery and once each day for 1 wk at rest (deep pain), shoulder and incision sites, and pain during coughing. Recovery was assessed by the time to transfer from Phase 1 to 2, the ability to walk, drink, and eat, and the ability to void. Plasma concentrations of ropivacaine were measured in eight patients. Time to ability to walk, defecation, driving a car, and return to normal activities were also recorded through a questionnaire sent home with the patient. During the first 4 postoperative h, patients in Group R had lower scores for deep pain and during coughing compared with Group P (P < 0.05). No differences were found in the postoperative consumption of ketobemidone. Median times to recovery at home were similar between the groups. By the seventh day, 93% of the patients had returned to normal activities of daily living. We conclude that the early postoperative pain after ambulatory laparoscopic cholecystectomy could be relieved using intermittent injections of ropivacaine 0.5% into the bed of the gall bladder.<br />Implications: Early postoperative pain can be relieved by intermittent injections of ropivacaine 0.5% through a catheter placed in the bed of the gall bladder after ambulatory laparoscopic cholecystectomy.
- Subjects :
- Aged
Amides adverse effects
Anesthetics, Local adverse effects
Catheterization
Double-Blind Method
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pain Measurement
Postoperative Nausea and Vomiting epidemiology
Ropivacaine
Surveys and Questionnaires
Time Factors
Amides administration & dosage
Amides therapeutic use
Anesthetics, Local administration & dosage
Anesthetics, Local therapeutic use
Cholecystectomy, Laparoscopic
Pain, Postoperative drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0003-2999
- Volume :
- 95
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Anesthesia and analgesia
- Publication Type :
- Academic Journal
- Accession number :
- 12145070
- Full Text :
- https://doi.org/10.1097/00000539-200208000-00040