[Analgesic efficacy and clinical safety of intraperitoneal instillation combined with rectus sheath block using ropivacaine for pain relief after laparoscopic gynecological surgery].
BACKGROUND
The aim of this study was to evaluate the analgesic efficacy and safety of rectus sheath block combined with intraperitoneal instillation using two doses of ropivacaine in patients undergoing laparoscopic gynecological surgery.


METHODS
Altogether 53 consenting women were randomized to receive intraperitoneal infiltration with 0.25% ropivacaine or 0.5% ropivacaine followed by rectus sheath block with 0.375% ropivacaine. The outcomes of clinical safety were measured using plasma concentration of local anesthetics and occurrence of toxic symptoms. The analgesic efficacy was assessed using numerical rating scales for pain and morphine consumption up to 24 hours after surgery.


RESULTS
Patients' baseline characteristics, surgical factors, and analgesic outcomes were comparable between the two groups. Although peak plasma concentration of ropivacaine was significantly higher in patients receiving 0.5% ropivacaine, none of analyzed concentrations was above the toxic ones. Besides, no patients showed any symptoms of local anesthetic toxicity.


CONCLUSIONS
The present study showed that the combination of rectus sheath block with intraperitoneal instillation of ropivacaine was safe and potent enough to relieve pain after laparoscopic surgery.
Chihiro
C
Yakoshi
Hiroshi
H
Hashimoto
Hidetomo
H
Niwa
Masatou
M
Kitayama
Tsuyoshi
T
Kudo
Mihoko
M
Kudo
Kazuyoshi
K
Hirota
D000328:Adult; D000577:Amides / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics; D000698:Analgesia / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics; D003131:Combined Modality Therapy; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007322:Instillation, Drug; D010535:Laparoscopy; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D017288:Pain Threshold; D010149:Postoperative Pain / Q000628:therapy*; D061214:Patient Safety; D010529:Peritoneal Cavity; D017568:Rectus Abdominis / Q000294:innervation*; D000077212:Ropivacaine; D016896:Treatment Outcome; D055815:Young Adult
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine