Dalmau Antònia, Fustran Noelia, Camprubi Imma, Sanzol Resurrección, Redondo Susana, Ramos Emilio, Torras Jaume, Sabaté Antoni
Acute Pain Clinic Division, Department of Anesthesia, Reanimation and Pain Clinic, Hospital Universitari de Bellvitge, Universitat de Barcelona Health Campus, IDIBELL, Barcelona, Spain.
Department of Anesthesia, Reanimation and Pain Clinic, Hospital Universitari de Bellvitge, Universitat de Barcelona Health Campus, IDIBELL, Barcelona, Spain.
Am J Surg. 2018 Jan;215(1):138-143. doi: 10.1016/j.amjsurg.2017.09.007. Epub 2017 Sep 20.
Surgical wound is source of pain in hepatectomy with laparotomy. Continuous wound infusion of ropivacaine may provide effective analgesia.
This prospective, randomized trial, patients scheduled for hepatectomy received a 48-h preperitoneal continuous wound infusion of either 0.23% ropivacaine or 0.9% saline at 5 ml/h. Primary endpoint was 48 h morphine consumption.
53 patients included in the ropivacaine group and 46 in the saline group. Morphine consumption was 24.63 mg in the ropivacaine group, and 26.78 mg (p = 0.669) in the saline group. Pain was comparable between groups and there were no differences in solid food intake, ambulation, or length of hospital stay. No local or systemic complications were recorded.
Continuous wound infusion with ropivacaine is safe, but it neither reduced morphine consumption nor enhanced recovery in patients undergoing hepatectomy. Success of enhanced recovery in hepatectomy is not influenced by the analgesic regimen if pain is well controlled.
剖腹肝切除术的手术切口是疼痛的来源。伤口持续输注罗哌卡因可能提供有效的镇痛效果。
在这项前瞻性随机试验中，计划接受肝切除术的患者以5毫升/小时的速度接受48小时的腹膜前伤口持续输注0.23%罗哌卡因或0.9%生理盐水。主要终点是48小时吗啡消耗量。
罗哌卡因组纳入53例患者，生理盐水组纳入46例患者。罗哌卡因组的吗啡消耗量为24.63毫克，生理盐水组为26.78毫克（p = 0.669）。两组之间的疼痛程度相当，在固体食物摄入量、活动能力或住院时间方面没有差异。未记录到局部或全身并发症。
伤口持续输注罗哌卡因是安全的，但它既没有减少肝切除患者的吗啡消耗量，也没有促进其恢复。如果疼痛得到良好控制，肝切除术中加速康复的成功不受镇痛方案的影响。
