Continuous wound infusion with ropivacaine: reduced pain after laparoscopy

  • Lee NH & al.
  • Surg Endosc
  • 13 Feb 2020

  • curated by Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • Patients who received continuous wound infusion (CWI) with ropivacaine after laparoscopy reported significantly less postoperative pain and needed fewer rescue analgesics than those who received CWI with saline.

Why this matters

  • Studies suggest CWI with local anesthetics reduces pain after cesarean section and open surgery, but data on its efficacy for pain relief after laparoscopic surgery were lacking.

Study design

  • 66 patients (mean age, 38.5±10.5 years) were randomly assigned to receive either ropivacaine or normal saline.
  • Outcomes: severity of postoperative pain and the number of rescue analgesics requested.
  • Funding: None.

Key results

  • Follow-up duration was 3 months.  
  • Ropivacaine CWI vs placebo had significantly lower:
    • Intensity of postoperative pain after:
      • 1 hour (P=.042).
      • 6 hours (P=.038).
      • 12 hours (P=.026).
      • 24 hours (P=.025).
      • 48 hours (P=.009).
    • Rescue analgesics consumption for:
      • Intramuscular diclofenac (P=.009).
      • Intramuscular pethidine (P=.014).  
  • Ropivacaine CWI vs placebo showed no significant differences for:
    • Operative time (P=.211).
    • Operative blood loss (P=.289).
    • Change in hemoglobin (P=.639).
    • Transfusion (P>.999).
    • Pathology (P>.999).  
    • Length of hospital stays (P=.558).

Limitations

  • All patients underwent single-port laparoscopy performed by a single surgeon.
  • Study involved only ropivacaine as experimental drug.

Coauthored with Vijay Rathod, PhD.