Continuous wound infiltration with ropivacaine reduces pain and analgesic requirement after shoulder surgery


Serval ID
Article: article from journal or magazin.
Continuous wound infiltration with ropivacaine reduces pain and analgesic requirement after shoulder surgery
Anesthesia and Analgesia
Gottschalk  A., Burmeister  M. A., Radtke  P., Krieg  M., Farokhzad  F., Kreissl  S., Strauss  M., Standl  T.
0003-2999 (Print)
Publication state
Issued date
1086-91, table of contents
Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't --- Old month value: Oct
After achieving a reduction of pain scores for 10 h with a single dose wound infiltration after shoulder surgery, we examined in a prospective, placebo-controlled and double-blinded study the analgesic effects of continuous wound infiltration with different concentrations of ropivacaine. Forty-five patients undergoing shoulder surgery were randomly assigned into three groups to receive single dose wound infiltration with 30 mL saline (group S) or ropivacaine 7.5 mg/mL (groups R2 and R3.75) after skin closure. Postoperatively, patients received a continuous wound infiltration with saline (group S), ropivacaine 2 mg/mL (group R2) or ropivacaine 3.75 mg/mL (group R3.75) for 48 h. Supplemental pain relief was provided by IV patient-controlled analgesia with the opioid piritramide. At 1, 2, 3, 4, 24, and 48 h postoperatively visual analogue scale (VAS) values (0-100 mm), piritramide requirements and side effects were registered. Plasma levels of ropivacaine were measured preoperatively and at 24 h and 48 h after surgery. Until 48 h VAS values were smaller in group R3.75 compared with group S (group R3.75, 8 +/- 9 mm; group S, 31 +/- 14 mm; P < 0.005), whereas 4 h and 48 h postoperatively VAS values were even smaller in group R3.75 compared with group R2 (P < 0.05). Cumulative piritramide consumption was always smaller in groups R2 and R3.75 compared with group S (1-24 h, P < 0.005; 48 h, P < 0.05). Plasma ropivacaine levels remained less than the toxic threshold. We conclude that continuous postoperative wound infiltration with ropivacaine, especially using 3.75 mg/mL, provides smaller VAS values and opioid requirement in comparison with saline after shoulder surgery. IMPLICATIONS: The continuous postoperative wound infiltration after shoulder surgery with different concentrations of ropivacaine, 2 mg/mL and 3.75 mg/mL, results in lower pain scores and opioid requirement compared with infiltration with placebo. Plasma levels of ropivacaine remained less than the toxic threshold.
Adult Amides/administration & dosage/pharmacokinetics/*therapeutic use Analgesics, Opioid/administration & dosage/*therapeutic use *Anesthesia, Local Anesthetics, Local/administration & dosage/pharmacokinetics/*therapeutic use Double-Blind Method Female Humans Male Middle Aged Pain Measurement Pain, Postoperative/epidemiology/*prevention & control Pirinitramide/administration & dosage/therapeutic use Postoperative Complications/epidemiology Postoperative Nausea and Vomiting/epidemiology Prospective Studies Shoulder/*surgery
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Create date
25/01/2008 14:52
Last modification date
20/08/2019 13:50
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