Wound infiltration with ropivacaine and fentanyl: Effects on postoperative pain and PONV after breast surgery

Summary, in English

Study Objective: To determine whether Postoperative wound infiltration with local anesthetics combined with fentanyl improves analgesia following breast surgery; and to investigate awakening and Postoperative nausea/vomiting. Design: Prospectively randomized clinical study. Setting: University hospital. Patients: 45 ASA physical status I and II patients scheduled for breast surgery. Interventions: Patients were prospectively randomized and assigned to one of three treatments during general anesthesia: postsurgical wound infiltration with ropivacaine 0.375%; wound infiltration with ropivacaine 0.375% combined with fentanyl 0.5 mug/kg; and intravenous (IV) fentanyl 0.5 mug/kg before skin incision and no wound infiltration. Time to first verbal response, Pain at rest, Postoperative nausea and vomiting, and ketobemidone and dixyrazine utilization were compared. Measurements and Main Results: Time to first verbal response was significantly shorter in the IV fentanyl group compared to both infiltration groups (8.1 +/- 4.5 min vs. 15.3 +/- 4.3, and 12.0 +/- 5.0 min; p < 0.05, respectively). Postoperative Pain at rest, and nausea and vomiting occurred with similar frequencies in the groups. Ketobemidone utilization in both infiltration groups, (2.4 +/- 1.8 mg and 3.1 +/- 1.8 mg, respectively) was not different compared to the IV fentanyl group (2.9 +/- 2.0 mg; NS). There were no differences in Postoperative antiemetic requirements during the first, second and third two-hour periods postoperatively. The dixyrazine consumption was similar in the three groups, (0.9 +/- 1.5 mg, 0.8 +/- 1.3 mg, and 1.4 +/- 1.8 mg, respectively; NS). Conclusion: Postsurgical ropivacaine wound infiltration, with or without adding fentanyl, demonstrates no differences in postoperative Pain relief and nausea/vomiting compared to a balanced general anesthetic including IV fentanyl. (C) 2003 by Elsevier Science Inc.

• Författare: Anders Johansson; J Kornfalt; L Nordin; L Svensson; Christian Ingvar; Johan Lundberg
• Avdelning/ar: Hälsa i ett tvärvetenskapligt perspektiv; Institutionen för kliniska vetenskaper, Lund; Anestesiologi och intensivvård
• Publiceringsår: 2003
• Språk: Engelska
• Sidor: 113-118
• Publikation/Tidskrift/Serie: Journal of Clinical Anesthesia
• Volym: 15
• Issue: 2
• Länkar: http://dx.doi.org/10.1016/S0952-8180(02)00511-1
• Dokumenttyp: Artikel i tidskrift
• Förlag: Elsevier
• Ämne: Anesthesiology and Intensive Care
• Nyckelord: local anesthetics; anesthetic technique; wound infiltration
• Status: Published
• Forskningsgrupp: Integrative Health Research
• ISBN/ISSN/Övrigt: ISSN: 1873-4529