Continuous Wound Infiltration with Ropivacaine Reduces Pain and Analgesic Requirement After Shoulder Surgery

Gottschalk, André; Burmeister, Marc-Alexander; Radtke, Patricia; Krieg, Marcus; Farokhzad, Faraneh; Kreissl, Sonja; Strauss, Matthias; Standl, Thomas

doi:10.1213/01.ane.0000081733.77457.79

Cited by 75 publications

(54 citation statements)

References 11 publications

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“…The plasma ropivacaine concentration in the present study continued to rise and failed to peak in most patients until the termination of infusion at 68 h. This is in contrast to the results of previous studies by Bianconi et al of wound instillation of ropivacaine 0.5% after orthopaedic surgery in which the peak concentration of ropivacaine occurred at 24 h and was less than 1.0 lg.ml )1 [30][31][32].…”

Section: Discussioncontrasting

confidence: 99%

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

Chan

Lai

Li³

et al. 2010

Anaesthesia

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SummaryThe 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) lg.ml )1 at the point when the infusion was terminated.

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Section: Discussioncontrasting

confidence: 99%

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

Chan

Lai

Li³

et al. 2010

Anaesthesia

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“…An option that has gained popularity is local infiltration with local anesthetics through the placement of an intraarticular catheter that allows for continuous local anesthetic infusion within the joint [4,7,14,17,19,22]. Recent studies have examined continuous intraarticular infusion of local anesthetic in orthopaedic surgery, concluding postoperative pain, the need for opioids as rescue medication, and mean length of hospital stay are reduced [4,8,10,14,19,21]. We undertook this study to analyze the possible benefits of continuous intraarticular infusion of ropivacaine in patients undergoing TKA.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Analgesia in TKA: Ropivacaine Continuous Intraarticular Infusion

Gómez-Cardero

Rodríguez-Merchán

2010

Clinical Orthopaedics &Amp; Related Research

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Background Postoperative pain control is a challenge in patients undergoing TKA due to side effects and technical limitations of current analgesic approaches. Local anesthetic infiltration through continuous infusion pumps has been shown to reduce postoperative pain in previous studies. Questions/purposes We assessed the effectiveness of intraarticular ropivacaine infusions in reducing pain and postoperative opioid use after TKA and determined whether such infusions accelerate functional recovery of the patient and reduce length of hospital stay. Methods In a randomized, prospective, double-blind study, two groups were assigned: Group A (n = 25) underwent continuous intraarticular infusion with 300 mL ropivacaine 0.2% at a speed of 5 mL/hour through an elastomeric infusion pump and Group B (n = 25) had an elastomeric pump insertion with 300 mL saline solution at an infusion speed of 5 mL/hour. All patients had the same prosthesis model implanted. Parameters analyzed over the first 3 days, at discharge, and 1 month later included postoperative pain, joint function, opioid use, and length of hospital stay.

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“…Elastomeric pain pumps delivering local anesthesia have been used by orthopaedic surgeons for many years for postoperative pain control after arthroscopic procedures of the knee and shoulder, but also after total joint arthroplasty [1,3,10,12,26]. Recent concerns of chondrolysis with continuous local anesthetic have limited the use in recent years in native joints [28,29,33].…”

Section: Introductionmentioning

confidence: 99%

The 2012 Chitranjan Ranawat Award: Intraarticular Analgesia After TKA Reduces Pain: A Randomized, Double-blinded, Placebo-controlled, Prospective Study

Goyal

McKenzie

Sharkey

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Postoperative pain after total knee arthroplasty remains one of the most important challenges facing patients undergoing this surgery. Providing a balance of adequate analgesia while limiting the functional impact of regional anesthesia and minimizing opioid side effects is critical to minimize adverse events and improve patient satisfaction. Questions/Purposes We asked whether bupivacaine delivered through an elastomeric device decreases the (1) patients' perception of pain after TKA; (2) narcotic consumption; and (3) narcotic-related side effects as compared with a placebo.Methods In this prospective, double-blind, placebocontrolled study, all patients received standardized regional anesthesia, a preemptive and multimodal analgesic protocol, and a continuous intraarticular infusion at 5 mL/hour through an elastomeric infusion pump. The patients were randomized to receive either an infusion pump filled with (1) 300 mL of 0.5% bupivacaine, the experimental group (n = 75); or (2) 300 mL of 0.9% normal saline solution, the control group (n = 75). Data concerning postoperative pain levels through a visual analog scale, postoperative opioid consumption, opioid-related side effects, and complications were collected and analyzed.

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Continuous Wound Infiltration with Ropivacaine Reduces Pain and Analgesic Requirement After Shoulder Surgery

Cited by 75 publications

References 11 publications

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

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

Postoperative Analgesia in TKA: Ropivacaine Continuous Intraarticular Infusion

The 2012 Chitranjan Ranawat Award: Intraarticular Analgesia After TKA Reduces Pain: A Randomized, Double-blinded, Placebo-controlled, Prospective Study

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