Aguirre GMP, Kuri OJA, Valente AB, Sánchez RJP, Martínez BP, González AJ

Language: Spanish
References: 15
Page: 110-113
PDF size: 179.39 Kb.

ABSTRACT

Introduction: Postoperative pain in anti reflux surgery, usually referred to the interescapular area often represents a limiting factor for the patient’s discharge affecting early mobilization and recovery. Material and methods: Comparative, randomized, double-blind trial of 94 patients that required a laparoscopic Nissen fundoplication. 47 patients in group 1, received 0.25 mL/kg of ropivacaine 7.5% spread on both diaphragmatic domes at the end of the procedure. The remaining 47 patients in group 2 did not receive intraperitoneal ropivacaine and were considered as the control group. The main results were obtained through the application of the visual analogue scale for pain at 2 and 6 hours postoperatively. Results: When the perception of pain according to visual analogue scale for pain was assessed, the control group had a higher score with statistically significant difference compared to the group with intraperitoneal application of ropivacaine at 2 and 6 hours of completion of the surgical procedure (2 hours 6.89 ± 1.32 versus 4.91 ± 1.76 p ‹ 0.001 and 6 hours 4.92 ± 1.35 versus 3.62 ± 1.31 p ‹ 0.001). Conclusions: Applying intraperitoneal ropivacaine in antireflux surgery is an effective and safe method for postoperative pain control.

REFERENCES

1. Bisgaard T, Stockel M, Karlskov B, Kehlet H, Rosenberg J. Prospective analysis of convalescence and early pain after uncomplicated laparoscopic fundoplication. Br J Surg. 2004; 91: 1473-1478.

2. Ingelmo PM, Bucciero M, Somaini M, Sahillioglu E, Garbagnati A, Charton A et al. Intraperitoneal nebulization of ropivacaine for pain control after laparoscopic cholecystectomy: a double-blind, randomized-controlled trial. Br J Anaesth. 2013; 110: 800-806.

3. Roberts K J, Gilmour J, Pande R, Nightingale P, Tan LC, Khan S. Efficacy of intraperitoneal local anesthetic techniques during laparoscopic cholecystectomy. Surg Endosc. 2011; 25: 3698-3705.

4. Kahokehr A, Sammour T, Srinivasa S, Hill AG. Systematic review and meta-analysis of intraperitoneal local anaesthetic for pain reduction after laparoscopic gastric procedures. Br J Surg. 2011; 98: 29-36.

5. Bielefeldt K, Christianson JA, Davis BM. Basic and clinical aspects of visceral sensation: transmission in the CNS. Neurogastroenterol Motil. 2005; 17: 488-499.

6. Lawlor P, Pereira J, Bruera E. Dose ratios among different opioids: underlying issues and an update on the use of the equianalgesic table. In: Bruera E, Portenoy RK. Topics in palliative care. Vol.5. Oxford University Press: New York, 2001, pp. 247-276.

7. Gupta A. Local anaesthesia for pain relief after laparoscopic cholecystectomy-a systematic review. Best Pract Res Clin Anaesthesiol. 2005; 19: 275-292.

8. Betton D, Greib N, Schlotterbeck H, Joshi GP, Ubeaud-Sequier G, Diemunsch P. The pharmacokinetics of ropivacaine after intraperitoneal administration: instillation versus nebulization. Anesth Analg. 2010; 111: 1140-1145.

9. Viamonte MA, Medina HJ. New local anaesthetics: promise or reality? Anales del Sistema Sanitario de Navarra. 1999; 22: 1-3.

10. Stoelting KR. Pharmacology and physiology in anesthetic practice. Edit. Lippincott-Raven. Tercera edición. 1999. United States of America, pp. 206-208.

11. Lönnqvist PA, Westrin P, Larsson BA, Olsson GL, Huledal G. Ropivacaine pharmacokinetics after caudal in 1-8 year old children. Br J Anaesth. 2000; 85: 506-511.

12. Labaille T, Mazoit JX, Paqueron X, Franco D, Benhamou D. The clinical efficacy and pharmacokinetics of intraperitoneal ropivacaine for laparoscopic cholecystectomy. Anesth Analg. 2002; 94: 100-105.

13. Marret E, Rolin M, Beaussier M, Bonnet F. Meta-analysis of intravenous lidocaine and postoperative recovery after abdominal surgery. Br J Surg. 2008; 95: 1331-1338.

14. Maestreoni U, Sortini D, Devito C, Pour Morad Kohan BF, Anania G, Pavanelli L, Pasqualucci A et al. A new method of preemptive analgesia in laparoscopic cholecystectomy. Surg Endosc. 2002; 16: 1336-1340.