The effect of intraperitoneal ropivacaine on pain after laparoscopic colectomy: a prospective randomized controlled trial.
BACKGROUND
Although laparoscopic procedures are becoming more common, postoperative pain remains a major factor causing delayed patient recovery. There have been several trials to reduce pain by instilling local anesthetics into the peritoneal cavity, but there has been no study on prolonged (∼300 min) or intensive surgery. We investigated the analgesic effect of intraperitoneal ropivacaine instillation after laparoscopic colectomy.


METHODS
Sixty patients were randomized to three groups. Twenty patients in each group received 50 mL of appropriate solutions after the formation of a pneumoperitoneum. The solution was normal saline (control) in group C and 1 mg/kg of ropivacaine in each of groups I and D. In group D, ropivacaine was sprayed again before the elimination of the pneumoperitoneum. Patients reported their postoperative pain using a subjective visual analogue scale. Fentanyl use for pain relief and frequency of pushing a button (FPB) for a bolus of patient controlled analgesia were evaluated, and scales of recovery rates were obtained.


RESULTS
The immediate postoperative pain score was lower in groups I and D than in group C. In groups I and D, FPB measures and fentanyl use were both less than in group C. The time taken to resume a regular diet was shorter in group D than in group C.


CONCLUSIONS
The intraperitoneal instillation of ropivacaine was effective in reducing postoperative pain and in shortening the recovery course after laparoscopic colectomy. The additional instillation of ropivacaine at the end of the surgery proved even more effective.
Park
Yong Hee
YH
Department of Anaesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.
Kang
Hyun
H
Woo
Young Cheol
YC
Park
Sun Gyoo
SG
Baek
Chong Wha
CW
Jung
Yong Hun
YH
Kim
Jin Yun
JY
Koo
Gill Hoi
GH
Kim
Seong Deok
SD
Park
Jun Seok
JS
D000328:Adult; D000368:Aged; D000577:Amides / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage*; D003082:Colectomy; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D007274:Injections, Intraperitoneal; D010535:Laparoscopy; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D011028:Pneumoperitoneum, Artificial; D011446:Prospective Studies; D000077212:Ropivacaine; D013997:Time Factors; D016896:Treatment Outcome
D000577:Amides; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000077212:Ropivacaine; D005283:Fentanyl