Año 2016 / Volumen 23 / Número 2

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Eficacia de la ropivacaína 0,1 % intraperitoneal en el control del dolor postoperatorio en cirugía ginecológica laparoscópica

Rev Soc Esp Dolor 2016; 23(2): 56-63

U. Ortega Mera, O. González Larrocha, J. Aguirre Aras, F. Mendoza Garces y A. Arizaga Maguregui1 FEA Servicio de Anestesia-Reanimación y 1Jefe de Servicio de Anestesia-Reanimación. Hospital de Galdakao-Usansolo. Vizcaya


ABSTRACT

Introduction: Determine the efficacy of preincisional ropiv- acaine 0,1 % intraperitoneal administration to control abdominal and/or shoulder pain after gynaecological laparoscopic surgery during the first week.

Design: Randomized and double-blinded trial.

Material and methods: 64 ASA I-III patients undergoing gy- naecological laparoscopic surgery for benign pathology were selected. After the pneumoperitoneum was done, 100 ml of

0.1 % ropivacaine or saline were administered intraperioteneal- ly. Patients received multimodal analgesia. Besides, a morphine PCA pump with a bolus option was prescribed.

Abdominal and/or shoulder pain were assessed, at rest and in motion, on waking up from anaesthesia, to 5,30,60 and 120 minutes and at 24 hours from the surgery. Mor- phine consumption were recorded in the first 24 hours and the presence of nausea and/or vomiting postoperatively. A week after the surgery, by a telephone survey, the shoulder pain after and the persistent abdominal pain on the seventh day was recorded.

Results: No significant differences in the ENV scale during the first 24 hours were observed. No differences in morphine consumption, in the incidence of nausea and/or vomiting or shoulder pain were observed. Statistically significant differences were noted in the incidence of persistent abdominal pain on the seventh day (18.52 treatment group vs. 57,58 % in control group with a p value 0.04).

Conclusions: The preincisional intraperitoneal administration of 100 ml of ropivacaine 0.1 % compared to administration of saline, in the context of an anesthetic and analgesic multimodal technique has not been shown to reduce postoperative pain, opioid consumption and the incidence of nausea and postoper- ative vomiting in the first 24 hours. Nor has it shown reduction of shoulder pain from the first day after undergoing gynecological laparoscopic surgery.

Ropivacaine 0.1 % intraperitoneal preincisional may be useful in the control of abdominal pain which persists on the seventh day.

Key words: Ropivacaine, pain, laparocopy, gynaecology.



 


 


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U. Ortega Mera, O. González Larrocha, J. Aguirre Aras, F. Mendoza Garces y A. Arizaga Maguregui1 FEA Servicio de Anestesia-Reanimación y 1Jefe de Servicio de Anestesia-Reanimación. Hospital de Galdakao-Usansolo. Vizcaya. Eficacia de la ropivacaína 0,1 % intraperitoneal en el control del dolor postoperatorio en cirugía ginecológica laparoscópica. Rev Soc Esp Dolor 2016; 23(2): 56-63


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