Continuous wound infiltration with ropivacaine reduces pain and analgesic requirement after shoulder surgery
Détails
ID Serval
serval:BIB_195BC0BD9BC3
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Continuous wound infiltration with ropivacaine reduces pain and analgesic requirement after shoulder surgery
Périodique
Anesthesia and Analgesia
ISSN
0003-2999 (Print)
Statut éditorial
Publié
Date de publication
10/2003
Volume
97
Numéro
4
Pages
1086-91, table of contents
Notes
Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't --- Old month value: Oct
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't --- Old month value: Oct
Résumé
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.
Mots-clé
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
Pubmed
Web of science
Création de la notice
25/01/2008 13:52
Dernière modification de la notice
20/08/2019 12:50