Randomized trial of subfascial infusion of ropivacaine for early recovery in laparoscopic colorectal cancer surgery.
10.4097/kjae.2016.69.6.604
- Author:
Sang Hyun LEE
1
;
Woo Seog SIM
;
Go Eun KIM
;
Hee Cheol KIM
;
Joo Hyun JUN
;
Jin Young LEE
;
Byung Seop SHIN
;
Heejin YOO
;
Sin Ho JUNG
;
Joungyoun KIM
;
Seung Hyeon LEE
;
Deok Kyu YO
;
Yu Ri NA
Author Information
1. Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. anesthe@skku.edu
- Publication Type:Original Article
- Keywords:
Analgesia;
Colorectal surgery;
Laparoscopy;
Local anesthetics;
Ropivacaine;
Subfascia
- MeSH:
Analgesia;
Analgesia, Patient-Controlled;
Anesthetics, Local;
Catheters;
Colorectal Neoplasms*;
Colorectal Surgery;
Cough;
Dizziness;
Fentanyl;
Flatulence;
Headache;
Humans;
Hypotension;
Laparoscopy;
Length of Stay;
Meperidine;
Methods;
Passive Cutaneous Anaphylaxis;
Postoperative Nausea and Vomiting;
Wounds and Injuries
- From:Korean Journal of Anesthesiology
2016;69(6):604-613
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: There is a need for investigating the analgesic method as part of early recovery after surgery tailored for laparoscopic colorectal cancer (LCRC) surgery. In this randomized trial, we aimed to investigate the analgesic efficacy of an inverse ‘v’ shaped bilateral, subfascial ropivacaine continuous infusion in LCRC surgery. METHODS: Forty two patients undergoing elective LCRC surgery were randomly allocated to one of two groups to receive either 0.5% ropivacaine continuous infusion at the subfascial plane (n = 20, R group) or fentanyl intravenous patient controlled analgesia (IV PCA) (n = 22, F group) for postoperative 72 hours. The primary endpoint was the visual analogue scores (VAS) when coughing at postoperative 24 hours. Secondary end points were the VAS at 1, 6, 48, and 72 hours, time to first flatus, time to first rescue meperidine requirement, rescue meperidine consumption, length of hospital stay, postoperative nausea and vomiting, sedation, hypotension, dizziness, headache, and wound complications. RESULTS: The VAS at rest and when coughing were similar between the groups throughout the study. The time to first gas passage and time to first rescue meperidine at ward were significantly shorter in the R group compared to the F group (P = 0.010). Rescue meperidine was administered less in the R group; however, without statistical significance. Other study parameters were not different between the groups. CONCLUSIONS: Ropivacaine continuous infusion with an inverse ‘v ’ shaped bilateral, subfascial catheter placement showed significantly enhanced bowel recovery and analgesic efficacy was not different from IV PCA in LCRC surgery.
