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The postoperative analgesic efficacy of wound instillation with ropivacaine 0.1% versus ropivacaine 0.2%.

AbstractSTUDY OBJECTIVES:
To assess the influence of ropivacaine concentration on wound instillation-induced postoperative analgesia following total abdominal hysterectomy with bilateral salpingo-oophorectomy.
DESIGN:
Prospective, randomized, double-blind study.
SETTING:
Large referral hospital.
PATIENTS:
40 ASA physical status I and II patients undergoing total abdominal hysterectomy with bilateral salpingo-oophorectomy.
INTERVENTIONS:
A standard general anesthetic was administered. In all cases surgery was performed via a Pfannenstiel incision. On completion of the surgery, a multi-orifice, 20-gauge epidural catheter was placed above the fascia such that the tip was sited at the point that demarcated 50% of the length of the surgical wound. Thereafter, the catheter was connected to an electronic patient-controlled analgesia (PCA) device programmed to deliver 9 mL of drug, with a lockout time of 60 minutes and no basal infusion. Patients were randomized to receive PCA with ropivacaine 0.1% (Group 0.1) or ropivacaine 0.2% (Group 0.2). During the first 6 postoperative hours, a co-investigator administered "rescue" morphine (2 mg IV). Thereafter, "rescue" meperidine 1 mg/kg was administered on patient request.
MEASUREMENTS AND MAIN RESULTS:
The number of attempts to activate the PCA device and actual PCA instillations during the 24 hour study period were similar between the groups. The number of 2 mg "rescue" morphine dosages administered was 4.3 +/- 1.7 versus 4.4 +/- 2.5 for the Group 0.1 and Group 0.2, respectively. For Group 0.1 and Group 0.2, the total dose of "rescue" morphine administered during the first 6 postoperative hours was 8.7 mg +/- 3.6 versus 9.1 mg +/- 5, respectively. "Rescue" meperidine administration during the subsequent 18 hours was similar between the groups. Throughout the study period, pain scores were similar between the groups.
CONCLUSION:
With a pre-set volume, varying the concentration of ropivacaine (0.1% versus 0.2%) does not affect the analgesic efficacy of wound instillation following total abdominal hysterectomy with bilateral salpingo-oophorectomy.
AuthorsEdna Zohar, Arie Shapiro, Alex Phillipov, David Hoppenstein, Zvi Klein, Brian Fredman
JournalJournal of clinical anesthesia (J Clin Anesth) Vol. 16 Issue 6 Pg. 399-404 (Sep 2004) ISSN: 0952-8180 [Print] United States
PMID15567641 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)
Chemical References
  • Amides
  • Analgesics, Opioid
  • Anesthetics, Local
  • Morphine
  • Ropivacaine
Topics
  • Amides (administration & dosage, therapeutic use)
  • Analgesia, Patient-Controlled
  • Analgesics, Opioid (administration & dosage, therapeutic use)
  • Anesthetics, Local (administration & dosage, therapeutic use)
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Humans
  • Hysterectomy
  • Instillation, Drug
  • Middle Aged
  • Morphine (administration & dosage, therapeutic use)
  • Ovariectomy
  • Pain Measurement (drug effects)
  • Pain, Postoperative (drug therapy)
  • Prospective Studies
  • Ropivacaine

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