Korean J Anesthesiol.
2016 Dec;69(6):604-613. 10.4097/kjae.2016.69.6.604.
Randomized trial of subfascial infusion of ropivacaine for early recovery in laparoscopic colorectal cancer surgery
- Affiliations
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- 1Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. anesthe@skku.edu
- 2Division of Colorectal Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 3Department of Anesthesiology and Pain Medicine, Kangnam Sacred Heart Hospital, Hallym University of College of Medicine, Seoul, Korea.
- 4Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Seoul, Korea.
- 5Department of Information Statistics, Chungbuk National University, Cheongju, Korea.
- KMID: 2360476
- DOI: http://doi.org/10.4097/kjae.2016.69.6.604
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.
MeSH Terms
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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
Anesthetics, Local
Fentanyl
Meperidine
