Analgesic efficacy of the incisional infiltration of ropivacaine vs ropivacaine with dexamethasone in the elective laparoscopic cholecystectomy

被引:0
作者
Evaristo-Mendez, Gerardo [1 ]
Garcia de Alba-Garcia, Javier Eduardo [2 ]
Ernesto Sahagun-Flores, Jose [3 ]
Antonio Ventura-Sauceda, Felix [1 ]
Uriel Mendez-Ibarra, Jorge [1 ]
Ricardo Sepulveda-Castro, Rogelio [1 ]
机构
[1] Hosp Reg Dr Valentin Gomez Farias, Dept Cirugia Gen, ISSSTE Zapopan, Zapopan 45150, Jalisco, Mexico
[2] IMSS Jalisco, Unidad Invest Social Epidemiol & Serv Salud, Guadalajara, Jalisco, Mexico
[3] Hosp Reg Dr Valentin Gomez Farias, Dept Invest, ISSSTE Zapopan, Zapopan 45150, Jalisco, Mexico
来源
CIRUGIA Y CIRUJANOS | 2013年 / 81卷 / 05期
关键词
Laparoscopic cholecystectomy; incisional pain; dexamethasone; POSTOPERATIVE PAIN; CONTROLLED-TRIAL; DOUBLE-BLIND; BUPIVACAINE; INJECTION; GLUCOCORTICOIDS; PARACETAMOL; MECHANISMS; INTENSITY; DURATION;
D O I
暂无
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Incisional pain is the main obstacle for elective laparoscopic cholecystectomy as an outpatient. We evaluated the analgesic efficacy of local infiltration of ropivacaine with dexamethasone (Rop/Dx), compared with ropivacaine (Rop) alone, during the first 24 hours postoperative of this surgery. Our hypothesis is that incisional pain intensity will be lower in patients of the group Rop/Dx. Methods: In a randomized, controlled, double-blind trial clinical, 80 patients were divided into two groups. Group Rop (n= 40) received pre and post-incisional infiltration with 150 mg of ropivacaine in 8 mL of 0.9% saline, while group Rop/Dx (n= 40) received 150 mg of ropivacaine with 8 mg of dexamethasone in 6 mL of 0.9% saline. The intensity of pain at rest and movement was assessed at 2, 4, 8, 12 and 24 hours postoperatively by a numerical rating scale of 11 points. Results: Incisional pain scores in group Rop/Dx were significantly lower, compared to the group Rop, at 12 hours (p= 0.05) and 24 hours (p= 0.01) at rest and at 12 hours (p= 0.04) and 24 hours (p= 0.01) during movement postoperatively. Conclusions: We found initial evidence that ropivacaine with dexamethasone for local infiltration decreased incisional pain intensity after 12 hours post-elective laparoscopic cholecystectomy with a good safety profile.
引用
收藏
页码:383 / 393
页数:11
相关论文
共 40 条
[1]   Characteristics and prediction of early pain after laparoscopic cholecystectomy [J].
Bisgaard, T ;
Klarskov, B ;
Rosenberg, J ;
Kehlet, H .
PAIN, 2001, 90 (03) :261-269
[2]   Preoperative dexamethasone improves surgical outcome after laparoscopic cholecystectomy - A randomized double-blind placebo-controlled trial [J].
Bisgaard, T ;
Klarskov, B ;
Kehlet, H ;
Rosenberg, J .
ANNALS OF SURGERY, 2003, 238 (05) :651-660
[3]   Additive analgesic effect of codeine and paracetamol can be detected in strong, but not moderate, pain after Caesarean section - Baseline pain-intensity is a determinant of assay-sensitivity in a postoperative analgesic trial [J].
Bjune, K ;
Stubhaug, BA ;
Dodgson, MS ;
Breivik, H .
ACTA ANAESTHESIOLOGICA SCANDINAVICA, 1996, 40 (04) :399-407
[4]   Effect of dexamethasone on the duration of interscalene nerve blocks with ropivacaine or bupivacaine [J].
Cummings, K. C., III ;
Napierkowski, D. E. ;
Parra-Sanchez, I. ;
Kurz, A. ;
Dalton, J. E. ;
Brems, J. J. ;
Sessler, D. I. .
BRITISH JOURNAL OF ANAESTHESIA, 2011, 107 (03) :446-453
[5]  
Davila FSA, 2010, CIR GEN, V32, P96
[6]   The interplay between the glucocorticoid receptor and nuclear factor-κB or activator protein-1:: Molecular mechanisms for gene repression [J].
De Bosscher, K ;
Vanden Berghe, W ;
Haegeman, G .
ENDOCRINE REVIEWS, 2003, 24 (04) :488-522
[7]   Perioperative Single Dose Systemic Dexamethasone for Postoperative Pain A Meta-analysis of Randomized Controlled Trials [J].
De Oliveira, Gildasio S., Jr. ;
Almeida, Marcela D. ;
Benzon, Honorio T. ;
McCarthy, Robert J. .
ANESTHESIOLOGY, 2011, 115 (03) :575-588
[8]   The visual analog scale in the immediate postoperative period: Intrasubject variability and correlation with a numeric scale [J].
DeLoach, LJ ;
Higgins, MS ;
Caplan, AB ;
Stiff, JL .
ANESTHESIA AND ANALGESIA, 1998, 86 (01) :102-106
[9]   Clinically important changes in acute pain outcome measures: A validation study [J].
Farrar, JT ;
Berlin, JA ;
Strom, BL .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 2003, 25 (05) :406-411
[10]   A Randomized, Double-Blind, Controlled Trial of Perioperative Administration of Gabapentin, Meloxicam and Their Combination for Spontaneous and Movement-Evoked Pain After Ambulatory Laparoscopic Cholecystectomy [J].
Gilron, Ian ;
Orr, Elizabeth ;
Tu, Dongsheng ;
Mercer, C. Dale ;
Bond, David .
ANESTHESIA AND ANALGESIA, 2009, 108 (02) :623-630