title: Continuous wound infiltration with ropivacaine for analgesia after caesarean section: a randomised, placebo-controlled trial.
abstract: BACKGROUND
  We evaluated the analgesic effect of ropivacaine infiltration into the surgical wound after caesarean section.
  
  
  METHODS
  In a double-blind trial, 67 patients who were scheduled for caesarean section under spinal anaesthesia were randomly assigned to receive either 0.75% ropivacaine or placebo (NaCl 0.9%) through a multi-orifice catheter that was placed into the surgical wound, between the muscle fascia and the subcutaneous tissue. The study drug was administered as a bolus of 10 ml at the end of the operation, followed by an infusion at 2 ml/h for 48 h. All patients were also given paracetamol and ibuprofen. The primary outcome was the total amount of rescue oxycodone needed during the first 48 h post-operatively. Secondary outcomes included pain and patient satisfaction scores. Analyses were according to intention to treat.
  
  
  RESULTS
  The mean (± standard deviation) amount of oxycodone administered during the first 48 h was 47.5 ± 20.9 mg in the ropivacaine group and 57.8 ± 29.4 mg in the placebo group (95% confidence interval for the difference between means, -22.8-2.2 mg; P = 0.10). There were no differences between the groups in pain scores or in patient satisfaction scores.
  
  
  CONCLUSIONS
  Continuous wound infiltration with ropivacaine did not decrease the need for opioids and had no impact on pain scores or patient satisfaction after caesarean section.
authors.affiliation: Department of Anaesthesiology and Intensive Care, North Karelia Central Hospital, Joensuu, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Reinikainen
authors.forename: S
authors.initials: S
authors.lastname: Syväoja
authors.forename: K
authors.initials: K
authors.lastname: Hara
mesh_terms: D000007:Abdominal Injuries / Q000188:drug therapy* / Q000209:etiology; D000082:Acetaminophen / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D000577:Amides / Q000008:administration & dosage* / Q000627:therapeutic use; D000698:Analgesia / Q000379:methods*; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D057785:Catheters; D002585:Cesarean Section; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage / Q000627:therapeutic use; D007322:Instillation, Drug; D009294:Narcotics / Q000008:administration & dosage / Q000627:therapeutic use; D010098:Oxycodone / Q000008:administration & dosage / Q000627:therapeutic use; D059408:Pain Management; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction; D011247:Pregnancy; D011446:Prospective Studies; D000077212:Ropivacaine; D014950:Wounds, Penetrating / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D009294:Narcotics; D000082:Acetaminophen; D000077212:Ropivacaine; D010098:Oxycodone; D007052:Ibuprofen