title: Intraperitoneal ropivacaine or ropivacaine plus meperidine for laparoscopic gynecological procedures.
abstract: OBJECTIVE
  Postoperative pain after laparoscopic surgery is less intense than after laparotomy and patients may benefit from an intraperitoneal injection of local anesthetic and opioids. We aimed to compare intraperitoneal 0.75% ropivacaine with 0.75% ropivacaine plus meperidine for postoperative analgesia in patients undergoing gynecologic laparoscopy.
  
  
  METHODS
  At the end of gynecologic laparoscopy, in a double-blind, randomized manner, one of the following injections was given intraperitoneally. Patients were allocated into three groups: Patients in R Group (n=18) were given 0.75% ropivacaine 3 mg/kg in 200 mL saline; patients in RM Group (n=17) were given meperidine 50 mg plus 0.75% ropivacaine 3 mg/kg in 200 mL saline; patients in C Group (n=18) were given 200 mL saline through the trocars. All patients were given diclofenac sodium when they had pain (VAS 3) and 1 mg/kg meperidine i.v. was also given when pain persisted.
  
  
  RESULTS
  The pain scores and analgesic requirements during the first postoperative hour were significantly lower in the RM Group than those in the R and C Groups. Beyond that time, the pain scores were similar in all groups and there were no differences in total analgesic requirement in 24 h between groups. The three groups were comparable for shoulder pain and side effects.
  
  
  CONCLUSIONS
  The intraperitoneal infiltration of 0.75% ropivacaine plus meperidine reduced pain scores and analgesic requirement during the first one hour after gynecologic laparoscopy compared with the intraperitoneal infiltration of ropivacaine or saline.
authors.affiliation: Department of Anesthesiology and Reanimation, Ege University Faculty of Medicine, İzmir, Turkey. semra.karaman@ege.edu.tr
authors.forename: Semra
authors.initials: S
authors.lastname: Karaman
authors.forename: Seden
authors.initials: S
authors.lastname: Kocabaş
authors.forename: Sedat
authors.initials: S
authors.lastname: Ergun
authors.forename: Vicdan
authors.initials: V
authors.lastname: Fırat
authors.forename: Meltem
authors.initials: M
authors.lastname: Uyar
authors.forename: Fatih
authors.initials: F
authors.lastname: Şendağ
mesh_terms: D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007274:Injections, Intraperitoneal; D010535:Laparoscopy; D008614:Meperidine / Q000008:administration & dosage*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D000077212:Ropivacaine; D016896:Treatment Outcome
chemical_list: D000577:Amides; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000077212:Ropivacaine; D008614:Meperidine