L’auto-administration de bupivacaïne ou de ropivacaïne au site d’incision procure une analgésie efficace a la suite d’une herniorraphie inguinale

Vintar, Neli; Pozlep, Gorazd; Rawal, Narinder; Godec, Marija; Rakovec, S

doi:10.1007/bf03017925

Cited by 47 publications

(29 citation statements)

References 15 publications

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“…in less pain and in a reduction of systemic morphine consumption [27,28]. Ropivacaine and bupivacaine are the most frequent used local anaesthetics in continuous wound infiltration without a difference in their pain control after inguinal hernia repair in a randomized, double-blinded controlled trial [29][30][31][32]. We chose ropivacaine because of its potential lower systemic toxicity and without any described and documented adverse effects [33][34][35].…”

Section: Discussionmentioning

confidence: 98%

Continuous local analgesic therapy reduces pain after radical inguinal/iliacal lymph node dissection

Neuß

Schomaker

Raue

et al. 2010

Langenbecks Arch Surg

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Section: Discussionmentioning

confidence: 98%

Continuous local analgesic therapy reduces pain after radical inguinal/iliacal lymph node dissection

Neuß

Schomaker

Raue

et al. 2010

Langenbecks Arch Surg

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“…Of the remaining 26 RCTs, 9 were excluded due to the infusion of analgesic mixtures [5,6,7,8] or the use of analgesic comedication [9,10,11,12,13]. While 3 RCTs using intermittent infusion technique [14,15,16] were identified, these 3 studies were considered insufficient in number to justify a separate meta-analysis for the IWI route of administration. The remaining 14 RCTs studied continuous infusion and were included in the systematic review and meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

Ropivacaine for Continuous Wound Infusion for Postoperative Pain Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2014

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Background: The use of continuous wound infusion (CWI) of local anaesthetics has been suggested as a safe and effective alternative technique to epidural anaesthesia/analgesia that allows surgeons to provide postoperative pain relief while reducing opioid consumption and associated adverse events. A previous meta-analysis by Liu et al. [Am Coll Surg 2006;203:914-932] reported results mainly from studies of bupivacaine. Subsequently, several new randomized controlled trials (RCTs) of ropivacaine have been published. This systematic review and quantitative meta-analysis evaluates the efficacy of ropivacaine for CWI. Methods: Systematic literature searches (EMBASE, MEDLINE) were performed to retrieve studies which met the following criteria: double-blind RCT of ropivacaine versus either placebo or an active comparator; use of ropivacaine solution without added active agents, and prohibition of other routine analgesics during the study period except rescue patient-controlled analgesia. For each included study, standardized effect sizes for ropivacaine versus placebo were calculated for opioid rescue use, pain score at rest, and pain score at mobilization. Meta-analyses were conducted for each endpoint. Results: Fourteen RCTs comparing ropivacaine (n = 376) versus placebo (n = 380) were identified. Effect size estimates revealed significantly less opioid rescue use for ropivacaine patients (-1.3; 95% CI -1.5 to -1.1) and significantly less pain for ropivacaine patients both at rest (-1.1; 95% CI -1.3 to -0.9) and on mobilization (-1.5; 95% CI -1.7 to -1.3). The weighted mean reduction in opioid rescue use was 22.4 mg. Conclusion: This systematic review and meta-analysis presents substantial evidence that ropivacaine provides clinically meaningful reductions in opioid use and pain outcomes. Ropivacaine CWI is effective for postoperative pain management in a wide range of surgical procedures.

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“…Vintar et al [60] noted that about 80% of patients who received bupivacaine and ropivacaine at the incision site were satisied with the outcome of the procedure and said they would use this treatment again.…”

Section: Patient-controlled Regional Analgesiamentioning

confidence: 99%

“…Vintar et al [60], in a controlled clinical trial, describes that the group which received the combination of ropivacaine/morphine/ketorolac required less use of rescue analgesics in relation to other groups.…”

Section: Patient-controlled Regional Analgesiamentioning

confidence: 99%

Patient-Controlled Analgesia (PCA) in Acute Pain: Pharmacological and Clinical Aspects

Fernandes¹,

Hernandes²,

Almeida³

et al. 2017

Pain Relief - From Analgesics to Alternative Therapies

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Moderate or severe pain are important sources of complications as well as morbidity and mortality in the postoperative period after surgical procedures. Patient-controlled analgesia (PCA) is an efective strategy for postoperative analgesia, since it may provide suitable analgesic dose just after system activation, with reduced periods of pain and an increase in patients' satisfaction. Although intravenous and epidural routes are the typical approaches used for PCA, regional patient-controlled analgesia has been shown to be an efective alternative providing a higher standard of analgesia with lower incidence of adverse efects. New devices and routes of PCA administration (transdermal, sublingual, inhalation, and oral routes) have shown to be promising alternatives in clinical studies. Nowadays, there is still no consensus regarding which is the best route or drug used since clinical eicacy/safety depends on the complex comprehension of the drugs pharmacokinetic proile through different routes of administration. Additionally, pharmacoeconomic studies are needed to evaluate the cost-efectiveness of these approaches.

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L’auto-administration de bupivacaïne ou de ropivacaïne au site d’incision procure une analgésie efficace a la suite d’une herniorraphie inguinale

Abstract: P Pu ur rp po os se e: : To evaluate the safety and applicability of two local anesthetic (LA) solutions self-administered for pain treatment after inguinal hernia repair (IHR) by balloon-pumps via catheters placed in the surgical wound. Effectiveness of analgesia was also compared.

Cited by 47 publications

References 15 publications

Continuous local analgesic therapy reduces pain after radical inguinal/iliacal lymph node dissection

Continuous local analgesic therapy reduces pain after radical inguinal/iliacal lymph node dissection

Ropivacaine for Continuous Wound Infusion for Postoperative Pain Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Patient-Controlled Analgesia (PCA) in Acute Pain: Pharmacological and Clinical Aspects

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