title: The analgesic efficacy of continuous elastomeric pump ropivacaine wound instillation after appendectomy.
abstract: OBJECTIVE
  To evaluate the analgesic efficacy and safety of ropivacaine 0.2% when administered continuously via elastomeric pump after appendectomy.
  
  
  METHODS
  Prospective, randomized, double-blinded study.
  
  
  METHODS
  Surgical ward of a university hospital.
  
  
  METHODS
  96 ASA physical status I and II patients of at least 14 years of age, undergoing appendectomy through a McBurney incision.
  
  
  METHODS
  Patients were randomly assigned into two groups: 500 mg of ropivacaine in 48 hours (10 mL of 0.2% ropivacaine 20 mg, starter dose plus 5 mL/h continuous wound infusion via elastomeric pump device; n = 48) in the experimental group and 250 mL of normal saline, as placebo, in the control group.
  
  
  METHODS
  Postappendectomy pain, measured either with a simple verbal scale or with a visual analog scale, parenteral analgesic consumption, and global satisfaction were all measured.
  
  
  RESULTS
  A reduction in postoperative pain was observed in the ropivacaine group. Degree of pain, with a simple verbal scale measurement of severe and unbearable, was significantly lower in the ropivacaine group than in the normal saline group from time 0 to 24 hours at rest and from time 0 to 36 hours on coughing. A significant lower pain intensity (visual analog scale) was found in the ropivacaine group both at rest and on coughing, beginning at three hours and continuing to 36 hours postoperatively. The mean number of rescue analgesic doses was significantly lower in the ropivacaine group. There were no statistically significant differences in the frequency of adverse events between the two groups.
  
  
  CONCLUSIONS
  Wound instillation with ropivacaine 0.2% is a useful, practical, and safe method for management of postoperative pain after appendectomy.
authors.affiliation: Unit of Emergency Surgery, Department of Surgical and Anaesthesiological Sciences, University of Bologna, Sant'Orsola-Malpighi Hospital, 40138 Bologna, Italy. lansaloni@orsola-malpighi.med.unibo.it
authors.forename: Luca
authors.initials: L
authors.lastname: Ansaloni
authors.forename: Vanni
authors.initials: V
authors.lastname: Agnoletti
authors.forename: Dario
authors.initials: D
authors.lastname: Bettini
authors.forename: Antonio
authors.initials: A
authors.lastname: Caira
authors.forename: Morena
authors.initials: M
authors.lastname: Calli
authors.forename: Fausto
authors.initials: F
authors.lastname: Catena
authors.forename: Miria
authors.initials: M
authors.lastname: Celotti
authors.forename: Angelo
authors.initials: A
authors.lastname: De Cataldis
authors.forename: Stefano
authors.initials: S
authors.lastname: Gagliardi
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Gasperoni
authors.forename: Antonio
authors.initials: A
authors.lastname: Leone
authors.forename: Rita Maria
authors.initials: RM
authors.lastname: Melotti
authors.forename: Antonella
authors.initials: A
authors.lastname: Potalivo
authors.forename: Gabriella
authors.initials: G
authors.lastname: Simoncini
authors.forename: Mario
authors.initials: M
authors.lastname: Taffurelli
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Di Nino
mesh_terms: D000293:Adolescent; D000328:Adult; D000577:Amides / Q000008:administration & dosage* / Q000009:adverse effects; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001062:Appendectomy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007260:Infusion Pumps; D008297:Male; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D000077212:Ropivacaine; D014947:Wounds and Injuries
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine