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

Anaesthesia. 2010 Dec;65(12):1180-6. doi: 10.1111/j.1365-2044.2010.06530.x. Epub 2010 Oct 19.

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.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Abdominal Wall
  • Adolescent
  • Adult
  • Aged
  • Amides / administration & dosage*
  • Amides / blood
  • Analgesics, Opioid / administration & dosage
  • Anesthetics, Local / administration & dosage*
  • Anesthetics, Local / 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

Substances

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