Effects of Peritoneal Ropivacaine Nebulization for Pain Control After Laparoscopic Gynecologic Surgery
| Autor: | Federica Lovisari, Emre Sahillioglu, Pablo Ingelmo, Alessandro Buda, Stefano Scalia Catenacci, Catherine E. Ferland, Roberto Fumagalli, Girish P. Joshi, Mario Bucciero, Mauro Gili, Valeria Rossini, Pierre Diemunsch, Pietro Brambillasca, Mauro Signorelli, Marta Somaini |
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| Přispěvatelé: | Somaini, M, Brambillasca, P, Ingelmo, P, Lovisari, F, Catenacci, S, Rossini, V, Bucciero, M, Sahillioglu, E, Buda, A, Signorelli, M, Gili, M, Joshi, G, Fumagalli, R, Ferland, C, Diemunsch, P |
| Rok vydání: | 2014 |
| Předmět: |
Adult
Insufflation medicine.medical_specialty Local anesthetic medicine.medical_treatment Anesthetic technique Regional technique Tertiary care Gynecologic Surgical Procedures Double-Blind Method Obstetrics and gynaecology Pain control Regional analgesic medicine Humans Infusions Parenteral Ropivacaine Anesthetics Local Postoperative Saline Early Ambulation Pain Measurement Pain Postoperative Morphine business.industry Nebulizers and Vaporizers Obstetrics and Gynecology Amides Confidence interval Surgery Analgesics Opioid Treatment Outcome Anesthesia Postoperative Nausea and Vomiting Female Laparoscopy business Acute pain medicine.drug |
| Zdroj: | Journal of Minimally Invasive Gynecology. 21:863-869 |
| ISSN: | 1553-4650 |
| DOI: | 10.1016/j.jmig.2014.03.021 |
| Popis: | 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 30 mg ropivacaine before surgery (preoperative group), nebulization of 30 mg ropivacaine after surgery (postoperative group), instillation of 100 mg 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 24 hours 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 4 hours, 1–3 at 6 hours, and 0.7–3 at 24 hours; p = .01) Patients in the preoperative group consumed significantly less morphine than did those in the control group (net difference 7 mg; 95% CI, 0.7–13; p = .02). More patients who received nebulization walked without assistance within 12 hours 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. |
| Databáze: | OpenAIRE |
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