title: Surgical Pain Control With Ropivacaine by Atomized Delivery (Spray): A Randomized Controlled Trial.
abstract: OBJECTIVE
  To investigate the role of intraoperative atomized intraperitoneal ropivacaine (AIR) as an adjuvant to anesthetic agents at the time of minimally invasive pelvic surgery.
  
  
  METHODS
  Double-blind, randomized controlled trial.
  
  
  METHODS
  
  
  
  METHODS
  Randomized controlled trial (Canadian Task Force classification I).
  
  
  METHODS
  Tertiary care teaching hospital.
  
  
  METHODS
  Fifty-five patients who underwent laparoscopic and robotic gynecologic procedures.
  
  
  METHODS
  Patients received AIR or atomized intraperitoneal saline (AIS) (dose, 2 mg/kg) immediately after the initiation of pneumoperitoneum.
  
  
  RESULTS
  Visual analog scale (VAS) pain scores and narcotic use (in morphine equivalents) were collected and recorded at 2, 4, 8, and 12 hours postoperatively.
  
  
  RESULTS
  Fifty-five patients completed the study protocol and data collection, with 30 patients allocated to the AIS group and 25 patients allocated to the AIR group. Demographic and surgical variables did not vary between the groups, with the exception of median operative duration. Postoperative VAS scores at 2, 4, 8, and 12 postoperative hours were higher in the AIS group, but the difference failed to reach statistical significance. Narcotic use was also similar in the 2 groups.
  
  
  CONCLUSIONS
  The use of intraperitoneal ropivacaine was not associated with a statistically significant difference in patients' postoperative VAS scores. Thus, in contrast to findings of similar studies performed in general surgery, AIR might not confer a benefit in women undergoing minimally invasive gynecologic procedures.
authors.affiliation: Department of Obstetrics and Gynecology, Loyola University Chicago Stritch School of Medicine, Maywood, IL. Electronic address: gg.garbe@gmail.com.
authors.forename: Gretchen G
authors.initials: GG
authors.lastname: Collins
authors.affiliation: Department of Obstetrics and Gynecology, Loyola University Chicago Stritch School of Medicine, Maywood, IL.
authors.forename: Jill A
authors.initials: JA
authors.lastname: Gadzinski
authors.affiliation: Department of Obstetrics and Gynecology, Loyola University Chicago Stritch School of Medicine, Maywood, IL.
authors.forename: Garrett D
authors.initials: GD
authors.lastname: Fitzgerald
authors.affiliation: Department of Obstetrics and Gynecology, Loyola University Chicago Stritch School of Medicine, Maywood, IL.
authors.forename: Jordan
authors.initials: J
authors.lastname: Sheran
authors.affiliation: Department of Obstetrics and Gynecology, Loyola University Chicago Stritch School of Medicine, Maywood, IL.
authors.forename: Sarah
authors.initials: S
authors.lastname: Wagner
authors.affiliation: Department of Anesthesia, Loyola University Chicago Stritch School of Medicine, Maywood, IL.
authors.forename: Steven
authors.initials: S
authors.lastname: Edelstein
authors.affiliation: Department of Urology and Obstetrics and Gynecology, Loyola University Chicago Stritch School of Medicine, Maywood, IL.
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Mueller
mesh_terms: D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D007274:Injections, Intraperitoneal; D007327:Insufflation / Q000295:instrumentation; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction; D000077212:Ropivacaine; D016896:Treatment Outcome
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine
keywords: Gynecology; Hysterectomy; Pain; Ropivacaine