The analgesic efficacy of continuous wound instillation with ropivacaine after open hepatic surgery.

Abstract

The analgesic efficacy of continuous local anaesthetic wound instillation after open hepatic surgery was evaluated. Forty-eight patients scheduled for elective liver surgery were assigned to receive either ropivacaine 0.25% or saline infusion at 4 ml.h(-1) for 68 h via two multi-orifice indwelling catheters placed within the musculo-fascial layer before skin closure; plasma ropivacaine concentrations were measured during the infusion. Supplemental analgesia was provided by intravenous patient-controlled analgesia morphine. Patients in the ropivacaine group had decreased mean (SD) total morphine consumption (58 (30) mg vs 86 (44) mg, p = 0.01) and less pain at rest as well as after spirometry at 4, 12, 24, 48 and 72 h postoperatively (p < 0.01). Forced vital capacity was reduced postoperatively in both groups, but the reduction was greater in the saline group at 12 and 24 h (p = 0.03). The mean plasma concentration of ropivacaine increased to 2.05 (0.78) μg.ml(-1) at the point when the infusion was terminated.

• Authors: S K Chan, P B Lai, P T Li, J Wong, M K Karmakar, K F Lee, T Gin
• Journal: Anaesthesia (Anaesthesia) Vol. 65 Issue 12 Pg. 1180-6 (Dec 2010) ISSN: 1365-2044 [Electronic] England
• PMID: 20958277 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Amides
• Analgesics, Opioid
• Anesthetics, Local
• Morphine
• Ropivacaine

Topics

• Abdominal Wall
• Adolescent
• Adult
• Aged
• Amides (administration & dosage, blood)
• Analgesics, Opioid (administration & dosage)
• Anesthetics, Local (administration & dosage, blood)
• Female
• Hepatectomy (methods)
• Humans
• Infusions, Intralesional
• Liver Neoplasms (surgery)
• Male
• Middle Aged
• Morphine (administration & dosage)
• Pain Measurement (methods)
• Pain, Postoperative (prevention & control)
• Postoperative Care (methods)
• Ropivacaine
• Vital Capacity (drug effects)
• Young Adult