Influence of Continuous Incision Infiltration with Ropivacaine on Postoperative Analgesia and Early Rehabilitation in Open Gastrectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 WANGXiao-lin , MARen-yuan , LIGuan-xiong , ZHANGZhe , YANGZhong-min

Department of General Surgery, The Second Hospital of Yulin City, Yulin 719000, Shaanxi Province, China;

Corresponding author：

WANGXiao-lin, Email: fuguren@126.com

Keywords：

Gastrectomy; Continuous incision infiltration; Ropivacaine; Pain

DOI：

10.7507/1007-9424.20150353

Video：

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Objective To assess postoperative analgesia and early rehabilitation of continuous incision infiltration with ropivacaine in open gastrectomy. Methods From June 2011 to October 2014, 50 patients underwent open gastrectomy were divided into two groups:standard analgesic therapy group (Abbreviation:standard group, n=25) and continuous incision infiltration with ropivacaine group (Abbreviation:ropivacaine group, n=25). All the patients were also given patient controlled intravenous analgesia (PCIA). Points of visual analog scale (VAS), Bruggrmann comfort scale (BCS), and nausea and vomiting were assessed at different time during the first 48 hours postoperatively. Total sufentanil dosage, the first postoperative ambulation time, bowel recovery time, postoperative hospital stay, and incision infection rate were compared between two groups. Results At 4 h, 8 h, 16 h, 24 h, 48 h postoperatively, the points of VAS in the ropivacaine group were significantly lower than those in the standard group (P < 0.05), the points of BCS in the ropivacaine group were significantly higher than those in the standard group (P < 0.05). Compared with the standard group, the dosage of sufentanil was significantly less (P < 0.05), the bowel recovery time, the first postoperative ambulation time, and the postoperative hospital stay were significantly shorter (P < 0.05), the point of nausea and vomiting was significantly lower (P < 0.05) at 48 h postoperatively in the ropivacaine group. There was no difference of the incision infection rate between the two groups (P > 0.05). Conclusion Continuous incision infiltration with ropivacaine is effective and safe to relief postoperative pain and accelerate patient's recovery after open gastrectomy.

Citation： WANGXiao-lin, MARen-yuan, LIGuan-xiong, ZHANGZhe, YANGZhong-min. Influence of Continuous Incision Infiltration with Ropivacaine on Postoperative Analgesia and Early Rehabilitation in Open Gastrectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(11): 1359-1362. doi: 10.7507/1007-9424.20150353 Copy

1.	徐建国.成人术后疼痛治疗进展.临床麻醉学杂志, 2011, 27(3):299-301.
2.	武娜, 李李.术后静脉镇痛临床用药新进展.长治医学院学报, 2014, 28(2):154-157.
3.	Yu N, Long X, Lujan-Hernandez JR, et al. Transversus abdominisplane block versus local anesthetic wound infiltration in lower abdominal surgery:a systematic review and meta-analysis of randomized controlled trials. BMC Anesthesiol, 2014, 14:121-130.
4.	高万露, 汪小海.患者疼痛评分法的术前选择及术后疼痛评估的效果分析.实用医学杂志, 2013, 29(23):3892-3894.
5.	王琳, 徐铭军.罗哌卡因局部浸润对妇科腹腔镜术后镇痛的影响研究.中国全科医学, 2014, 17(15):1719-1722.
6.	Kehlet H, Holte K. Effect of postoperative analgesia on surgical outcome. Br J Anaesth, 2001, 87(1):62-72.
7.	Dahl JB, Kehlet H. Preventive analgesia. Curr Opin Anaesthesiol, 2011, 24(3):331-338.
8.	Argoff CE. Recent management advances in acute postoperative pain. Pain Pract, 2014, 14(5):477-487.
9.	Yeh YC, Lin TF, Lin FS, et al. Combination of opioid agonist and agonist-antagonist:patient-controlled analgesia requirement and adverse events among different-ratio morphine and nalbuphine admixtures for postoperative pain. Br J Anaesth, 2008, 101(4):542-548.
10.	Vigneau A, Salengro A, Berger J, et al. A double blind randomized trial of wound infiltration with ropivacaine after breast cancer surgery with axillary nodes dissection. BMC Anesthesiol, 2011, 11:23-28.
11.	Loizides S, Gurusamy KS, Nagendran M, et al. Wound infiltration with local anaesthetic agents for laparoscopic cholecystectomy. Cochrane Database Syst Rev, 2014, 3:CD007049.
12.	Ducarme G, Sillou S, Wernet A, et al. Single-shot ropivacaine wound infiltration during cesarean section for postoperative pain relief. Gynecol Obstet Fertil, 2012, 40(1):10-13.
13.	Banerjee P, Rogers BA. Systematic review of high-volume multimodal wound infiltration in total knee arthroplasty. Orthopedics, 2014, 37(6):403-412.
14.	Forastiere E, Sofra M, Giannarelli D, et al. Effectiveness of continuous wound infusion of 0.5% ropivacaine by On-Q pain relief system for postoperative pain management after open nephrectomy. Br J Anaesth, 2008, 101(6):841-847.
15.	Li M, Wan L, Mei W, et al. Update on the clinical utility and practical use of ropivacaine in Chinese patients. Drug Des Devel Ther, 2014, 8:1269-1276.
16.	Wang RD, Dangler LA, Greengrass RA. Update on ropivacaine. Expert Opin Pharmacother, 2001, 2(12):2051-2063.
17.	Gutton C, Bellefleur JP, Puppo S, et al. Lidocaine versus ropivacaine for perineal infiltration post-episiotomy. Int J Gynaecol Obstet, 2013, 122(1):33-36.
18.	Chan SK, Lai PB, Li PT, et al. The analgesic efficacy of continuous wound instillation with ropivacaine after open hepatic surgery. Anaesthesia, 2010, 65(12):1180-1186.
19.	Wang D, Kong Y, Zhong B, et al. Fast-track surgery improves postoperative recovery in patients with gastric cancer:a randomized comparison with conventional postoperative care. J Gastrointest Surg, 2010, 14(4):620-627.
20.	Ducrotté P, Caussé C. The bowel function index:a new validated scale for assessing opioid-induced constipation. Curr Med Res Opin, 2012, 28(3):457-466.
21.	虞洪, 李哲勇, 俞欣.开腹肝切除术后罗哌卡因持续切口浸润麻醉疗效观察.中华医学杂志, 2013, 93(34):2723-2726.
22.	吕赤, 张忻平, 李瑾, 等.开腹胃肠道术后局部麻醉镇痛与静脉自控镇痛的临床效果比较.中华全科医学, 2014, 12(4):531-533.
23.	Lluis F, Romero Simó M, Márquez Peiró JF, et al. Safety of a multiperforated catheter implanted in the surgical wound for the continuous infusion of local anaesthetics in post-operative analgesia. Cir Esp, 2011, 89(9):613-617.
24.	吴刚, 叶向阳, 孙少珍, 等.用加速康复外科理念治疗胃癌患者的临床应用探讨.中国普外基础与临床杂志, 2012, 19(6):657-661.

1. 徐建国.成人术后疼痛治疗进展.临床麻醉学杂志, 2011, 27(3):299-301.
2. 武娜, 李李.术后静脉镇痛临床用药新进展.长治医学院学报, 2014, 28(2):154-157.
3. Yu N, Long X, Lujan-Hernandez JR, et al. Transversus abdominisplane block versus local anesthetic wound infiltration in lower abdominal surgery:a systematic review and meta-analysis of randomized controlled trials. BMC Anesthesiol, 2014, 14:121-130.
4. 高万露, 汪小海.患者疼痛评分法的术前选择及术后疼痛评估的效果分析.实用医学杂志, 2013, 29(23):3892-3894.
5. 王琳, 徐铭军.罗哌卡因局部浸润对妇科腹腔镜术后镇痛的影响研究.中国全科医学, 2014, 17(15):1719-1722.
6. Kehlet H, Holte K. Effect of postoperative analgesia on surgical outcome. Br J Anaesth, 2001, 87(1):62-72.
7. Dahl JB, Kehlet H. Preventive analgesia. Curr Opin Anaesthesiol, 2011, 24(3):331-338.
8. Argoff CE. Recent management advances in acute postoperative pain. Pain Pract, 2014, 14(5):477-487.
9. Yeh YC, Lin TF, Lin FS, et al. Combination of opioid agonist and agonist-antagonist:patient-controlled analgesia requirement and adverse events among different-ratio morphine and nalbuphine admixtures for postoperative pain. Br J Anaesth, 2008, 101(4):542-548.
10. Vigneau A, Salengro A, Berger J, et al. A double blind randomized trial of wound infiltration with ropivacaine after breast cancer surgery with axillary nodes dissection. BMC Anesthesiol, 2011, 11:23-28.
11. Loizides S, Gurusamy KS, Nagendran M, et al. Wound infiltration with local anaesthetic agents for laparoscopic cholecystectomy. Cochrane Database Syst Rev, 2014, 3:CD007049.
12. Ducarme G, Sillou S, Wernet A, et al. Single-shot ropivacaine wound infiltration during cesarean section for postoperative pain relief. Gynecol Obstet Fertil, 2012, 40(1):10-13.
13. Banerjee P, Rogers BA. Systematic review of high-volume multimodal wound infiltration in total knee arthroplasty. Orthopedics, 2014, 37(6):403-412.
14. Forastiere E, Sofra M, Giannarelli D, et al. Effectiveness of continuous wound infusion of 0.5% ropivacaine by On-Q pain relief system for postoperative pain management after open nephrectomy. Br J Anaesth, 2008, 101(6):841-847.
15. Li M, Wan L, Mei W, et al. Update on the clinical utility and practical use of ropivacaine in Chinese patients. Drug Des Devel Ther, 2014, 8:1269-1276.
16. Wang RD, Dangler LA, Greengrass RA. Update on ropivacaine. Expert Opin Pharmacother, 2001, 2(12):2051-2063.
17. Gutton C, Bellefleur JP, Puppo S, et al. Lidocaine versus ropivacaine for perineal infiltration post-episiotomy. Int J Gynaecol Obstet, 2013, 122(1):33-36.
18. Chan SK, Lai PB, Li PT, et al. The analgesic efficacy of continuous wound instillation with ropivacaine after open hepatic surgery. Anaesthesia, 2010, 65(12):1180-1186.
19. Wang D, Kong Y, Zhong B, et al. Fast-track surgery improves postoperative recovery in patients with gastric cancer:a randomized comparison with conventional postoperative care. J Gastrointest Surg, 2010, 14(4):620-627.
20. Ducrotté P, Caussé C. The bowel function index:a new validated scale for assessing opioid-induced constipation. Curr Med Res Opin, 2012, 28(3):457-466.
21. 虞洪, 李哲勇, 俞欣.开腹肝切除术后罗哌卡因持续切口浸润麻醉疗效观察.中华医学杂志, 2013, 93(34):2723-2726.
22. 吕赤, 张忻平, 李瑾, 等.开腹胃肠道术后局部麻醉镇痛与静脉自控镇痛的临床效果比较.中华全科医学, 2014, 12(4):531-533.
23. Lluis F, Romero Simó M, Márquez Peiró JF, et al. Safety of a multiperforated catheter implanted in the surgical wound for the continuous infusion of local anaesthetics in post-operative analgesia. Cir Esp, 2011, 89(9):613-617.
24. 吴刚, 叶向阳, 孙少珍, 等.用加速康复外科理念治疗胃癌患者的临床应用探讨.中国普外基础与临床杂志, 2012, 19(6):657-661.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Influence of Continuous Incision Infiltration with Ropivacaine on Postoperative Analgesia and Early Rehabilitation in Open Gastrectomy

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