Effect of local wound infiltration with ropivacaine on postoperative pain relief and stress response reduction after open hepatectomy

Sun, Jian; Bai, Ke-Yun; Liu, Yanfeng; Du, Gang; Fu, Zhihao; Zhang, Hao; Yang, Jinhuan; Wang, Ben; Wang, Xiuyu; Jin, Bin

doi:10.3748/wjg.v23.i36.6733

Cited by 20 publications

(24 citation statements)

References 23 publications

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“…The VAS scores in the first 24 hours were obviously lower in the patients who received LIA than the control patients, and the total opioid use via PCA within 72 hours was also less in the LIA patients than in the control patients. These findings are similar to those of previous studies 14,20,21 . Furthermore, we calculated the periodic consumption of sufentanil in the first 72 hours after surgery and found that the ropivacaine group used less opioid analgesics than the control group at each follow-up point in the first 24 hours postoperatively.…”

Section: Discussionsupporting

confidence: 93%

Efficacy of local infiltration analgesia with ropivacaine for postoperative pain management in cervical laminoplasty: a retrospective study

Luo

et al. 2020

Sci Rep

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Poor postoperative pain control impairs patient recovery and lengthens the duration of hospitalization after various surgeries. Local infiltration analgesia(LIA) has become an effective method for managing postoperative pain. This study aimed to investigate the efficacy of LIA with ropivacaine for postoperative pain control after cervical laminoplasty. In total, 68 patients undergoing cervical laminoplasty were included for retrospective review and divided into ropivacaine and control groups. The visual analogue scale (VAS) score, postoperative analgesic consumption, operative duration, intraoperative blood loss volume, incision length, hospitalization duration and incidence of complications were analyzed. In the ropivacaine group, the VAS score was 3.2 ± 1.4 at 4 hours postoperatively, which was lower than that of the control group(4.0 ± 1.4, P = 0.024). At 8, 12 and 24 hours after surgery, a significant difference was detected in the VAS score between the two groups(P ≤ 0.015). Sufentanil consumption was less in the ropivacaine group than in the control group in the first 4 hours postoperatively (25.6 ± 6.3 µg vs 32.2 ± 6.8 µg, P < 0.001), and similar results were observed in the first 8, 12, 24, 48 and 72 hours postoperatively(P < 0.001). Fewer patients required rescue analgesia in the ropivacaine group(8/33 vs 18/35 at 4-8 hours, P = 0.021; 9/33 vs 21/35 at 8-12 hours, P = 0.007). The hospitalization duration and time to ambulation were shorter in the ropivacaine group(8.5 ± 1.4 vs 9.6 ± 1.6 for postoperative duration, P = 0.002; 2.9 ± 0.7 vs 3.5 ± 0.8 for time to ambulation, P = 0.001). The incidence of nausea and vomiting was lower in the ropivacaine group than in the control group(30.3% vs 54.3%, P = 0.046). In conclusion, LIA with ropivacaine could effectively reduce postoperative pain, and postoperative analgesic consumption, and promote recovery after cervical laminoplasty. Cervical laminoplasty has been used widely and achieved satisfactory outcomes in treating multilevel cervical lesions, including cervical spondylotic myelopathy(CSM), congenital cervical stenosis(CCS), and ossification of the posterior longitudinal ligament(OPLL) 1-3. However, surgical treatment often results in serious pain, which can impair patient recovery and lengthen the hospitalization duration. Recently, local infiltration analgesia (LIA) has emerged as a good choice for postoperative analgesia due to its simplicity and low-cost 4,5. LIA has been used in various surgeries with favorable outcomes and without major side effects 6. The benefits of LIA in spinal surgery are also well known; however, its use has been limited to lumbar decompression and discectomy, and spinal fusion surgery 7,8. Few studies have focused on the effect of LIA on postoperative pain control in cervical laminoplasty. Therefore, we conducted this clinical study to retrospectively evaluate the efficacy of LIA with ropivacaine for managing postoperative pain after cervical laminoplasty.

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Section: Discussionsupporting

confidence: 93%

Efficacy of local infiltration analgesia with ropivacaine for postoperative pain management in cervical laminoplasty: a retrospective study

Luo

et al. 2020

Sci Rep

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“…Postoperative pain is a serious problem for patients after splenectomy. The curved incision damages many muscles and afferent nerves, contributing to postoperative pain [1,2]. Postoperative pain not only leads to discomfort and inhibits recovery but also prolongs hospitalization.…”

Section: Discussionmentioning

confidence: 99%

“…Splenectomy performed via a curved incision from the subxiphoid region to the anterior axillary line along the left subcostal margin results in injury to muscles, such as the rectus abdominis muscle, the external oblique muscle, the internal oblique muscle and the transversus abdominis muscle, etc. [1]. These broad injuries of the upper abdominal wall are the main contributors to severe postoperative pain [2], resulting in postoperative complications and a prolonged duration of recovery after the operation [3].…”

Section: Introductionmentioning

confidence: 99%

The combination of transversus abdominis plane block and rectus sheath block reduced postoperative pain after splenectomy: a randomized trial

et al. 2020

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Background: Splenectomy performed with a curved incision results in severe postoperative pain. The aim of this study was to evaluate the effect of transversus abdominis plane block and rectus sheath block on postoperative pain relief and recovery. Methods: A total of 150 patients were randomized into the control (C), levobupivacaine (L) and levobupivacaine/ morphine (LM) groups. The patients in the C group received only patient-controlled analgesia. The patients in the L and LM groups received transversus abdominis plane block and rectus sheath block with levobupivacaine or levobupivacaine plus morphine. The intraoperative opioid consumption; postoperative pain score; time to first analgesic use; postoperative recovery data, including the times of first exhaust, defecation, oral intake and offbed activity; the incidence of postoperative nausea and vomiting and antiemetics use; and the satisfaction score were recorded. Results: Transversus abdominis plane block and rectus sheath block reduced intraoperative opioid consumption. The patients in the LM group showed lower postoperative pain scores, opioid consumption, postoperative nausea and vomiting incidence and antiemetic use and presented shorter recovery times and higher satisfaction scores. Conclusions: The combination of transversus abdominis plane block and rectus sheath block with levobupivacaine and morphine can improve postoperative pain relief, reduce the consumption of analgesics, and partly accelerate postoperative recovery.

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“…To reduce the side effects of opioids, multimodal analgesia has been used in perioperative pain management. As a new method of multimodal analgesia, local wound infiltration anaesthesia plays an important role in alleviating postoperative acute wound pain, reducing opioid use, and facilitating fast recovery . This method uses only local anaesthetic drugs, such as ropivacaine and bupivacaine, and provides adequate analgesic effects.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of dexmedetomidine as an adjuvant to local wound infiltration anaesthesia in abdominal surgery: A meta‐analysis of randomised controlled trials

Ren

Shi

Chen

et al. 2019

International Wound Journal

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To assess the efficacy and safety of dexmedetomidine (DEX) as an adjuvant to local wound infiltration anaesthesia in abdominal surgery, we conducted this meta‐analysis. First, the systematic search strategy was performed on PubMed, Embase, and Cochrane Library and five randomised controlled trials (RCTs) involving 294 patients were included. Then, the outcome data were extracted from the studies and their effect sizes were calculated using Review Manager 5. As a result, the addition of DEX significantly reduced visual analogy scores at 6 hours after surgery (mean difference = −0.53[−0.82, −0.25], P < .001), 12 hours after surgery (mean difference = −0.39 [−0.73, −0.05]; P = .03), and 24 hours after surgery (mean difference = −0.20 [−0.29, −0.11], P < .001) and reduced total analgesic consumption within 24 hours after surgery (mean difference = −4.92 [−9.00, −0.84]; P = .02) compared with placebo groups. However, there was no difference in the incidence of postoperative nausea and vomiting (risk ratio = 0.68 [0.41, 1.14]; P = .14). In summary, DEX as a local anaesthetic adjuvant added for local wound infiltration anaesthesia in abdominal surgery could reduce visual analogy scores and postoperative analgesic consumption without changing incidence of postoperative nausea and vomiting.

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Effect of local wound infiltration with ropivacaine on postoperative pain relief and stress response reduction after open hepatectomy

Cited by 20 publications

References 23 publications

Efficacy of local infiltration analgesia with ropivacaine for postoperative pain management in cervical laminoplasty: a retrospective study

Efficacy of local infiltration analgesia with ropivacaine for postoperative pain management in cervical laminoplasty: a retrospective study

The combination of transversus abdominis plane block and rectus sheath block reduced postoperative pain after splenectomy: a randomized trial

Efficacy of dexmedetomidine as an adjuvant to local wound infiltration anaesthesia in abdominal surgery: A meta‐analysis of randomised controlled trials

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