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
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.
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
ly. Patients received multimodal analgesia. Besides, a morphine PCA pump with a bolus option was prescribed.
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
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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