TY - JOUR
T1 - Effects of Peritoneal Ropivacaine Nebulization for Pain Control After Laparoscopic Gynecologic Surgery
AU - Somaini, Marta
AU - Brambillasca, Pietro
AU - Ingelmo, Pablo Mauricio
AU - Lovisari, Federica
AU - Catenacci, Stefano Scalia
AU - Rossini, Valeria
AU - Bucciero, Mario
AU - Sahillioglu, Emre
AU - Buda, Alessandro
AU - Signorelli, Mauro
AU - Gili, Mauro
AU - Joshi, Girish
AU - Fumagalli, Roberto
AU - Ferland, Catherine E.
AU - Diemunsch, Pierre
N1 - Publisher Copyright:
© 2014 AAGL.
PY - 2014/9/1
Y1 - 2014/9/1
N2 - Study Objective: To evaluate the effects of peritoneal cold nebulization of ropivacaine on pain control after gynecologic laparoscopy. Design: Evidence obtained from a properly designed, randomized, double-blind, placebo-controlled trial (Canadian Task Force classification I). Setting: Tertiary care center. Patients: One hundred thirty-five women with American Society of Anesthesiologists disease classified as ASA I-III who were scheduled to undergo operative laparoscopy. Intervention: Patients were randomized to receive either nebulization of 30mg ropivacaine before surgery (preoperative group), nebulization of 30mg ropivacaine after surgery (postoperative group), instillation of 100mg ropivacaine before surgery (instillation group), or instillation of saline solution (control group). Nebulization was performed using the Aeroneb Pro device. Measurement and Main Results: Pain scores, morphine consumption, and ambulation time were collected in the post-anesthesia care unit and at 4, 6, and 24hours postoperatively. One hundred eighteen patients completed the study. Patients in the preoperative group reported lower pain Numeric Ranking Scale values compared with those in the control group (net difference 2 points; 95% confidence interval [CI], 0.3-3.1 at 4hours, 1-3 at 6hours, and 0.7-3 at 24hours; p=.01) Patients in the preoperative group consumed significantly less morphine than did those in the control group (net difference 7mg; 95% CI, 0.7-13; p=.02). More patients who received nebulization walked without assistance within 12hours after awakening than did those in the instillation and control groups (net difference 15%; 95% CI, 6%-24%; p=.001). Conclusions: Cold nebulization of ropivacaine before surgery reduced postoperative pain and morphine consumption and was associated with earlier walking without assistance.
AB - Study Objective: To evaluate the effects of peritoneal cold nebulization of ropivacaine on pain control after gynecologic laparoscopy. Design: Evidence obtained from a properly designed, randomized, double-blind, placebo-controlled trial (Canadian Task Force classification I). Setting: Tertiary care center. Patients: One hundred thirty-five women with American Society of Anesthesiologists disease classified as ASA I-III who were scheduled to undergo operative laparoscopy. Intervention: Patients were randomized to receive either nebulization of 30mg ropivacaine before surgery (preoperative group), nebulization of 30mg ropivacaine after surgery (postoperative group), instillation of 100mg ropivacaine before surgery (instillation group), or instillation of saline solution (control group). Nebulization was performed using the Aeroneb Pro device. Measurement and Main Results: Pain scores, morphine consumption, and ambulation time were collected in the post-anesthesia care unit and at 4, 6, and 24hours postoperatively. One hundred eighteen patients completed the study. Patients in the preoperative group reported lower pain Numeric Ranking Scale values compared with those in the control group (net difference 2 points; 95% confidence interval [CI], 0.3-3.1 at 4hours, 1-3 at 6hours, and 0.7-3 at 24hours; p=.01) Patients in the preoperative group consumed significantly less morphine than did those in the control group (net difference 7mg; 95% CI, 0.7-13; p=.02). More patients who received nebulization walked without assistance within 12hours after awakening than did those in the instillation and control groups (net difference 15%; 95% CI, 6%-24%; p=.001). Conclusions: Cold nebulization of ropivacaine before surgery reduced postoperative pain and morphine consumption and was associated with earlier walking without assistance.
KW - Acute pain
KW - Anesthetic techniques
KW - Insufflation
KW - Local anesthetics
KW - Postoperative
KW - Regional analgesics
KW - Regional techniques
KW - Ropivacaine
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U2 - 10.1016/j.jmig.2014.03.021
DO - 10.1016/j.jmig.2014.03.021
M3 - Article
C2 - 24727030
AN - SCOPUS:84908167120
SN - 1553-4650
VL - 21
SP - 863
EP - 869
JO - Journal of Minimally Invasive Gynecology
JF - Journal of Minimally Invasive Gynecology
IS - 5
ER -