Anesth Analg 2002;95:450-456
© 2002 International Anesthesia Research Society
REGIONAL ANESTHESIA
Postoperative Pain Relief Using Intermittent Injections of 0.5% Ropivacaine Through a Catheter After Laparoscopic Cholecystectomy
Anil Gupta, MD FRCA, PhD* ,
Sven E. Thörn, MD PhD*,
Kjell Axelsson, MD PhD*,
Lars G. Larsson, MD ,
Göran Ågren, MD,
Björn Holmström, MD PhD*, and
Narinder Rawal, MD PhD*
Departments of *Anesthesiology and Intensive Care, Surgery, and Division for Ambulatory Surgery, University Hospital, Örebro, Sweden
Address correspondence and reprint requests to Anil Gupta, MD, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medical Institutions, 600 N Wolfe St, Carnegie 280, Baltimore, MD 21287. Address e-mail to anil_guptarca{at}hotmail.com
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.
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.
This article has been cited by other articles:
|
|
|
|
 
P. F. White, H. Kehlet, J. M. Neal, T. Schricker, D. B. Carr, F. Carli, and the Fast-Track Surgery Study Group
The Role of the Anesthesiologist in Fast-Track Surgery: From Multimodal Analgesia to Perioperative Medical Care
Anesth. Analg.,
June 1, 2007;
104(6):
1380 - 1396.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. P. Boddy, S. Mehta, and M. Rhodes
The effect of intraperitoneal local anesthesia in laparoscopic cholecystectomy: a systematic review and meta-analysis.
Anesth. Analg.,
September 1, 2006;
103(3):
682 - 688.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. F. White
The Changing Role of Non-Opioid Analgesic Techniques in the Management of Postoperative Pain
Anesth. Analg.,
November 1, 2005;
101(5S_Suppl):
S5 - 22.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Gupta, A. Perniola, K. Axelsson, S. E. Thorn, K. Crafoord, and N. Rawal
Postoperative Pain After Abdominal Hysterectomy: A Double-Blind Comparison Between Placebo and Local Anesthetic Infused Intraperitoneally
Anesth. Analg.,
October 1, 2004;
99(4):
1173 - 1179.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
