title: Intraperitoneal Ropivacaine Irrigation in Patients Undergoing Bariatric Surgery: a Prospective Randomized Clinical Trial.
abstract: Despite most bariatric procedures are actually performed by laparoscopic approach, management of postoperative pain remains a major challenge. The aim of this study was to analyze the analgesic effect of intraperitoneal ropivacaine infusion in patients undergoing bariatric surgery.
  
  
  
  A prospective randomized clinical trial of all the patients undergoing laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) between January and November 2015 was performed. Patients were randomized to experimental (EG: those patients undergoing intraperitoneal ropivacain irrigation) and control groups (CG: those undergoing intraperitoneal irrigation with normal saline).
  
  
  
  One hundred ten patients were included, 83 LRYGB (75.5 %) and 27 LSG (24.5 %). Mean pain, as measured by VAS score, was 21.7 ± 14.5 mm in CG and 13.3 ± 10.9 mm in EG (p = 0.002). Morphine needs during the first 24 h postoperatively were 21.8 % in CG and 3.6 % in EG (p = 0.01). Early taking of fluids by mouth was possible 6 h after surgery in 76.4 % in EG vs 34.5 % in CG (p = 0.001). Early mobilization ability (6 h after surgery) was feasible in 72.7 % in EG and 32.7 % in CG (p = 0.001). Median hospital stay was 3 days (range 2-10 days) in CG and 2 days (2-7 days) in EG (p = 0.009).
  
  
  
  The intraoperative peritoneal infusion with ropivacaine in patients undergoing bariatric surgery is associated with a reduction in postoperative pain, lower morphine needs, earlier mobilization and earlier oral intake of fluids after surgery, and a shorter hospital stay. ClinicalTrials.gov Identifier: NCT02641288.
authors.affiliation: University Hospital Rey Juan Carlos, Mostoles, Madrid, Spain. jruiztovar@gmail.com.
authors.forename: Jaime
authors.initials: J
authors.lastname: Ruiz-Tovar
authors.affiliation: University Hospital Rey Juan Carlos, Mostoles, Madrid, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Gonzalez
authors.affiliation: University Hospital Rey Juan Carlos, Mostoles, Madrid, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Garcia
authors.affiliation: University Hospital Rey Juan Carlos, Mostoles, Madrid, Spain.
authors.forename: Consuelo
authors.initials: C
authors.lastname: Cruz
authors.affiliation: University Hospital Rey Juan Carlos, Mostoles, Madrid, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Rivas
authors.affiliation: University Hospital Rey Juan Carlos, Mostoles, Madrid, Spain.
authors.forename: Montiel
authors.initials: M
authors.lastname: Jimenez
authors.affiliation: University Hospital Rey Juan Carlos, Mostoles, Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Ferrigni
authors.affiliation: University Hospital Rey Juan Carlos, Mostoles, Madrid, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Duran
mesh_terms: D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D050110:Bariatric Surgery / Q000379:methods; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000601:surgery*; D010149:Postoperative Pain / Q000188:drug therapy*; D010533:Peritoneal Lavage; D011446:Prospective Studies; D000077212:Ropivacaine
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine
keywords: Bariatric surgery; Intraperitoneal irrigation; Postoperative pain; Ropivacaine