Effects of Peritoneal Ropivacaine Nebulization for Pain Control After Laparoscopic Gynecologic Surgery

Marta Somaini, Pietro Brambillasca, Pablo Mauricio Ingelmo, Federica Lovisari, Stefano Scalia Catenacci, Valeria Rossini, Mario Bucciero, Emre Sahillioglu, Alessandro Buda, Mauro Signorelli, Mauro Gili, Girish Joshi, Roberto Fumagalli, Catherine E. Ferland, Pierre Diemunsch

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)863-869
Number of pages7
JournalJournal of Minimally Invasive Gynecology
Volume21
Issue number5
DOIs
Publication statusPublished - Sep 1 2014

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Keywords

  • Acute pain
  • Anesthetic techniques
  • Insufflation
  • Local anesthetics
  • Postoperative
  • Regional analgesics
  • Regional techniques
  • Ropivacaine

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Somaini, M., Brambillasca, P., Ingelmo, P. M., Lovisari, F., Catenacci, S. S., Rossini, V., ... Diemunsch, P. (2014). Effects of Peritoneal Ropivacaine Nebulization for Pain Control After Laparoscopic Gynecologic Surgery. Journal of Minimally Invasive Gynecology, 21(5), 863-869. https://doi.org/10.1016/j.jmig.2014.03.021