The Effect of Intraperitoneal Ropivacaine on Pain after Laparoscopic Colectomy: A Prospective Randomized Controlled Trial

Park, Yong‐Hee; Kang, Hyun; Woo, Young Cheol; Park, Sun Gyoo; Baek, Chong Wha; Jung, Yong Hun; Kim, Jin Yun; Koo, Gill Hoi; Kim, Seong Deok; Park, Jun Seok

doi:10.1016/j.jss.2010.03.024

Cited by 34 publications

(34 citation statements)

References 18 publications

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“…Park et al . assessed IPLA for laparoscopic colectomy by spraying the peritoneal cavity with ropivacaine at completion of resection, and demonstrated lower pain scores and fentanyl usage to 48 h in the treatment group. Duffield et al .…”

Section: Discussionmentioning

confidence: 99%

The LAPLAP study: a randomized placebo‐controlled clinical trial assessing postoperative functional recovery using intraperitoneal local anaesthetic in laparoscopic colorectal surgery

et al. 2019

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Aim Postoperative pain remains a major factor in recovery from colorectal resection. There is increasing interest in opioid‐sparing analgesia, and intraperitoneal local anaesthetic (IPLA) has recently been shown to be useful in minor laparoscopic and open colorectal procedures. The aim of this study was to evaluate the impact of IPLA on functional recovery following major laparoscopic surgery. In this controlled trial, mobility, as measured by the De Morton Mobility Index (DEMMI), was used as a surrogate for postoperative functional recovery. Method Patients undergoing laparoscopic colorectal resection were randomized either to continuous ropivacaine (0.2% at 4–6 ml/h) or to saline (0.9%) which were administered via intraperitoneal catheter for 3 days postoperatively. Results were analysed in a double‐blind manner. DEMMIs were assessed on postoperative days 1, 2, 3, 7 and 30, and data on pain, opioid consumption, gut and respiratory function, length of stay (LOS) and complications were recorded. Results Ninety‐six patients were recruited. There was no difference in primary outcome (i.e., functional recovery) between IPLA and placebo groups. Opioid consumption and LOS were similar between groups, and no differences were found for any secondary outcome measure. There were no adverse events related to ropivacaine. Conclusion Infusional intraperitoneal local anaesthetic appears to be safe but does not improve functional recovery or analgesic consumption following elective laparoscopic colorectal surgery, in the setting of an established enhanced recovery programme.

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Section: Discussionmentioning

confidence: 99%

The LAPLAP study: a randomized placebo‐controlled clinical trial assessing postoperative functional recovery using intraperitoneal local anaesthetic in laparoscopic colorectal surgery

et al. 2019

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“…Intraperitoneal instillation of local anesthetics during major abdominal surgery, including open and laparoscopic colectomy, is associated with significantly lower pain scores postoperatively; although one study did continue TEA in addition to intraperitoneal instillation for 2 days after surgery (Marks et al 2012; Kahokehr et al 2011; Park et al 2011). Additionally, wound infiltration has been shown to be associated with a decrease in morphine consumption and significantly lower pain scores in the early postoperative period in abdominal surgery patients, but none specifically in colorectal surgery (Bamigboye and Hofmeyr 2009).…”

Section: Resultsmentioning

confidence: 99%

American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on optimal analgesia within an enhanced recovery pathway for colorectal surgery: part 1—from the preoperative period to PACU

et al. 2017

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BackgroundWithin an enhanced recovery pathway (ERP), the approach to treating pain should be multifaceted and the goal should be to deliver “optimal analgesia,” which we define in this paper as a technique that optimizes patient comfort and facilitates functional recovery with the fewest medication side effects.MethodsWith input from a multi-disciplinary, international group of clinicians, and through a structured review of the literature and use of a modified Delphi method, we achieved consensus surrounding the topic of optimal analgesia in the perioperative period for colorectal surgery patients.DiscussionAs a part of the first Perioperative Quality Improvement (POQI) workgroup meeting, we sought to develop a consensus document describing a comprehensive, yet rational and practical, approach for developing an evidence-based plan for achieving optimal analgesia, specifically for a colorectal surgery ERP. The goal was two-fold: (a) that application of this process would lead to improved patient outcomes and (b) that investigation of the questions raised would identify knowledge gaps to aid the direction for research into analgesia within ERPs in the years to come. This document details the evidence for a wide range of analgesic components, with particular focus from the preoperative period to the post-anesthesia care unit. The overall conclusion is that the combination of analgesic techniques employed in the perioperative period is not important as long as it is effective in delivering the goal of optimal analgesia as set forth in this document.

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“…Other pharmacological and nonpharmacological treatments might also be used in order to decrease morphine consumption. In adults patients intravenous lidocaine,[18] preoperative gabapentin[192021] or intraperitoneal or wound local anesthetics administration[18222324] have been previously found to decrease postoperative opioid requirement and improve postoperative pain relieve. However, their use in children is limited by the lack of evidences.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting recovery of postoperative bowel function after pediatric laparoscopic surgery

Michelet

Andreu-Gallien²,

Skhiri

et al. 2016

J Anaesthesiol Clin Pharmacol

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Background and Aims:Laparoscopic pediatric surgery allows a rapid postoperative rehabilitation and hospital discharge. However, the optimal postoperative pain management preserving advantages of this surgical technique remains to be determined. This study aimed to identify factors affecting the postoperative recovery of bowel function after laparoscopic surgery in children.Material and Methods:A retrospective analysis of factors affecting recovery of bowel function in children and infants undergoing laparoscopic surgery between January 1, 2009 and September 30, 2009, was performed. Factors included were: Age, weight, extent of surgery (extensive, regional or local), chronic pain (sickle cell disease or chronic intestinal inflammatory disease), American Society of Anaesthesiologists status, postoperative analgesia (ketamine, morphine, nalbuphine, paracetamol, nonsteroidal anti-inflammatory drugs [NSAIDs], nefopam, regional analgesia) both in the Postanesthesia Care Unit and in the surgical ward; and surgical complications. Data analysis used classification and regression tree analysis (CART) with a 10-fold cross validation.Results:One hundred and sixty six patients were included in the analysis. Recovery of bowel function depended upon: The extent of surgery, the occurrence of postoperative surgical complications, the administration of postoperative morphine in the surgical ward, the coadministration of paracetamol and NSAIDs and/or nefopam in the surgical ward and the emergency character of the surgery. The CART method generated a decision tree with eight terminal nodes. The percentage of explained variability of the model and the cross validation were 58% and 49%, respectively.Conclusion:Multimodal analgesia using nonopioid analgesia that allows decreasing postoperative morphine consumption should be considered for the speed of bowel function recovery after laparoscopic pediatric surgery.

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The Effect of Intraperitoneal Ropivacaine on Pain after Laparoscopic Colectomy: A Prospective Randomized Controlled Trial

Cited by 34 publications

References 18 publications

The LAPLAP study: a randomized placebo‐controlled clinical trial assessing postoperative functional recovery using intraperitoneal local anaesthetic in laparoscopic colorectal surgery

The LAPLAP study: a randomized placebo‐controlled clinical trial assessing postoperative functional recovery using intraperitoneal local anaesthetic in laparoscopic colorectal surgery

American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on optimal analgesia within an enhanced recovery pathway for colorectal surgery: part 1—from the preoperative period to PACU

Factors affecting recovery of postoperative bowel function after pediatric laparoscopic surgery

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