Effects of Peritoneal Ropivacaine Nebulization for Pain Control After Laparoscopic Gynecologic Surgery

Marta Somaini, Pietro Brambillasca, Pablo Mauricio Ingelmo, Federica Lovisari, Stefano Scalia Catenacci, Valeria Rossini, Mario Bucciero, Emre Sahillioglu, Alessandro Buda, Mauro Signorelli, Mauro Gili, Girish Joshi, Roberto Fumagalli, Catherine E. Ferland, Pierre Diemunsch

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Study Objective: To evaluate the effects of peritoneal cold nebulization of ropivacaine on pain control after gynecologic laparoscopy. Design: Evidence obtained from a properly designed, randomized, double-blind, placebo-controlled trial (Canadian Task Force classification I). Setting: Tertiary care center. Patients: One hundred thirty-five women with American Society of Anesthesiologists disease classified as ASA I-III who were scheduled to undergo operative laparoscopy. Intervention: Patients were randomized to receive either nebulization of 30mg ropivacaine before surgery (preoperative group), nebulization of 30mg ropivacaine after surgery (postoperative group), instillation of 100mg ropivacaine before surgery (instillation group), or instillation of saline solution (control group). Nebulization was performed using the Aeroneb Pro device. Measurement and Main Results: Pain scores, morphine consumption, and ambulation time were collected in the post-anesthesia care unit and at 4, 6, and 24hours postoperatively. One hundred eighteen patients completed the study. Patients in the preoperative group reported lower pain Numeric Ranking Scale values compared with those in the control group (net difference 2 points; 95% confidence interval [CI], 0.3-3.1 at 4hours, 1-3 at 6hours, and 0.7-3 at 24hours; p=.01) Patients in the preoperative group consumed significantly less morphine than did those in the control group (net difference 7mg; 95% CI, 0.7-13; p=.02). More patients who received nebulization walked without assistance within 12hours after awakening than did those in the instillation and control groups (net difference 15%; 95% CI, 6%-24%; p=.001). Conclusions: Cold nebulization of ropivacaine before surgery reduced postoperative pain and morphine consumption and was associated with earlier walking without assistance.

Original languageEnglish
Pages (from-to)863-869
Number of pages7
JournalJournal of Minimally Invasive Gynecology
Volume21
Issue number5
DOIs
Publication statusPublished - Sep 1 2014

Fingerprint

Gynecologic Surgical Procedures
Laparoscopy
Pain
Morphine
Control Groups
Confidence Intervals
Walking
Advisory Committees
Postoperative Pain
Tertiary Care Centers
Sodium Chloride
ropivacaine
Anesthesia
Placebos
Equipment and Supplies

Keywords

  • Acute pain
  • Anesthetic techniques
  • Insufflation
  • Local anesthetics
  • Postoperative
  • Regional analgesics
  • Regional techniques
  • Ropivacaine

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Medicine(all)

Cite this

Somaini, M., Brambillasca, P., Ingelmo, P. M., Lovisari, F., Catenacci, S. S., Rossini, V., ... Diemunsch, P. (2014). Effects of Peritoneal Ropivacaine Nebulization for Pain Control After Laparoscopic Gynecologic Surgery. Journal of Minimally Invasive Gynecology, 21(5), 863-869. https://doi.org/10.1016/j.jmig.2014.03.021

Effects of Peritoneal Ropivacaine Nebulization for Pain Control After Laparoscopic Gynecologic Surgery. / Somaini, Marta; Brambillasca, Pietro; Ingelmo, Pablo Mauricio; Lovisari, Federica; Catenacci, Stefano Scalia; Rossini, Valeria; Bucciero, Mario; Sahillioglu, Emre; Buda, Alessandro; Signorelli, Mauro; Gili, Mauro; Joshi, Girish; Fumagalli, Roberto; Ferland, Catherine E.; Diemunsch, Pierre.

In: Journal of Minimally Invasive Gynecology, Vol. 21, No. 5, 01.09.2014, p. 863-869.

Research output: Contribution to journalArticle

Somaini, M, Brambillasca, P, Ingelmo, PM, Lovisari, F, Catenacci, SS, Rossini, V, Bucciero, M, Sahillioglu, E, Buda, A, Signorelli, M, Gili, M, Joshi, G, Fumagalli, R, Ferland, CE & Diemunsch, P 2014, 'Effects of Peritoneal Ropivacaine Nebulization for Pain Control After Laparoscopic Gynecologic Surgery', Journal of Minimally Invasive Gynecology, vol. 21, no. 5, pp. 863-869. https://doi.org/10.1016/j.jmig.2014.03.021
Somaini, Marta ; Brambillasca, Pietro ; Ingelmo, Pablo Mauricio ; Lovisari, Federica ; Catenacci, Stefano Scalia ; Rossini, Valeria ; Bucciero, Mario ; Sahillioglu, Emre ; Buda, Alessandro ; Signorelli, Mauro ; Gili, Mauro ; Joshi, Girish ; Fumagalli, Roberto ; Ferland, Catherine E. ; Diemunsch, Pierre. / Effects of Peritoneal Ropivacaine Nebulization for Pain Control After Laparoscopic Gynecologic Surgery. In: Journal of Minimally Invasive Gynecology. 2014 ; Vol. 21, No. 5. pp. 863-869.
@article{5bfcaecb8582409da6a4d40954b9b504,
title = "Effects of Peritoneal Ropivacaine Nebulization for Pain Control After Laparoscopic Gynecologic Surgery",
abstract = "Study Objective: To evaluate the effects of peritoneal cold nebulization of ropivacaine on pain control after gynecologic laparoscopy. Design: Evidence obtained from a properly designed, randomized, double-blind, placebo-controlled trial (Canadian Task Force classification I). Setting: Tertiary care center. Patients: One hundred thirty-five women with American Society of Anesthesiologists disease classified as ASA I-III who were scheduled to undergo operative laparoscopy. Intervention: Patients were randomized to receive either nebulization of 30mg ropivacaine before surgery (preoperative group), nebulization of 30mg ropivacaine after surgery (postoperative group), instillation of 100mg ropivacaine before surgery (instillation group), or instillation of saline solution (control group). Nebulization was performed using the Aeroneb Pro device. Measurement and Main Results: Pain scores, morphine consumption, and ambulation time were collected in the post-anesthesia care unit and at 4, 6, and 24hours postoperatively. One hundred eighteen patients completed the study. Patients in the preoperative group reported lower pain Numeric Ranking Scale values compared with those in the control group (net difference 2 points; 95{\%} confidence interval [CI], 0.3-3.1 at 4hours, 1-3 at 6hours, and 0.7-3 at 24hours; p=.01) Patients in the preoperative group consumed significantly less morphine than did those in the control group (net difference 7mg; 95{\%} CI, 0.7-13; p=.02). More patients who received nebulization walked without assistance within 12hours after awakening than did those in the instillation and control groups (net difference 15{\%}; 95{\%} CI, 6{\%}-24{\%}; p=.001). Conclusions: Cold nebulization of ropivacaine before surgery reduced postoperative pain and morphine consumption and was associated with earlier walking without assistance.",
keywords = "Acute pain, Anesthetic techniques, Insufflation, Local anesthetics, Postoperative, Regional analgesics, Regional techniques, Ropivacaine",
author = "Marta Somaini and Pietro Brambillasca and Ingelmo, {Pablo Mauricio} and Federica Lovisari and Catenacci, {Stefano Scalia} and Valeria Rossini and Mario Bucciero and Emre Sahillioglu and Alessandro Buda and Mauro Signorelli and Mauro Gili and Girish Joshi and Roberto Fumagalli and Ferland, {Catherine E.} and Pierre Diemunsch",
year = "2014",
month = "9",
day = "1",
doi = "10.1016/j.jmig.2014.03.021",
language = "English",
volume = "21",
pages = "863--869",
journal = "Journal of Minimally Invasive Gynecology",
issn = "1553-4650",
publisher = "Elsevier",
number = "5",

}

TY - JOUR

T1 - Effects of Peritoneal Ropivacaine Nebulization for Pain Control After Laparoscopic Gynecologic Surgery

AU - Somaini, Marta

AU - Brambillasca, Pietro

AU - Ingelmo, Pablo Mauricio

AU - Lovisari, Federica

AU - Catenacci, Stefano Scalia

AU - Rossini, Valeria

AU - Bucciero, Mario

AU - Sahillioglu, Emre

AU - Buda, Alessandro

AU - Signorelli, Mauro

AU - Gili, Mauro

AU - Joshi, Girish

AU - Fumagalli, Roberto

AU - Ferland, Catherine E.

AU - Diemunsch, Pierre

PY - 2014/9/1

Y1 - 2014/9/1

N2 - Study Objective: To evaluate the effects of peritoneal cold nebulization of ropivacaine on pain control after gynecologic laparoscopy. Design: Evidence obtained from a properly designed, randomized, double-blind, placebo-controlled trial (Canadian Task Force classification I). Setting: Tertiary care center. Patients: One hundred thirty-five women with American Society of Anesthesiologists disease classified as ASA I-III who were scheduled to undergo operative laparoscopy. Intervention: Patients were randomized to receive either nebulization of 30mg ropivacaine before surgery (preoperative group), nebulization of 30mg ropivacaine after surgery (postoperative group), instillation of 100mg ropivacaine before surgery (instillation group), or instillation of saline solution (control group). Nebulization was performed using the Aeroneb Pro device. Measurement and Main Results: Pain scores, morphine consumption, and ambulation time were collected in the post-anesthesia care unit and at 4, 6, and 24hours postoperatively. One hundred eighteen patients completed the study. Patients in the preoperative group reported lower pain Numeric Ranking Scale values compared with those in the control group (net difference 2 points; 95% confidence interval [CI], 0.3-3.1 at 4hours, 1-3 at 6hours, and 0.7-3 at 24hours; p=.01) Patients in the preoperative group consumed significantly less morphine than did those in the control group (net difference 7mg; 95% CI, 0.7-13; p=.02). More patients who received nebulization walked without assistance within 12hours after awakening than did those in the instillation and control groups (net difference 15%; 95% CI, 6%-24%; p=.001). Conclusions: Cold nebulization of ropivacaine before surgery reduced postoperative pain and morphine consumption and was associated with earlier walking without assistance.

AB - Study Objective: To evaluate the effects of peritoneal cold nebulization of ropivacaine on pain control after gynecologic laparoscopy. Design: Evidence obtained from a properly designed, randomized, double-blind, placebo-controlled trial (Canadian Task Force classification I). Setting: Tertiary care center. Patients: One hundred thirty-five women with American Society of Anesthesiologists disease classified as ASA I-III who were scheduled to undergo operative laparoscopy. Intervention: Patients were randomized to receive either nebulization of 30mg ropivacaine before surgery (preoperative group), nebulization of 30mg ropivacaine after surgery (postoperative group), instillation of 100mg ropivacaine before surgery (instillation group), or instillation of saline solution (control group). Nebulization was performed using the Aeroneb Pro device. Measurement and Main Results: Pain scores, morphine consumption, and ambulation time were collected in the post-anesthesia care unit and at 4, 6, and 24hours postoperatively. One hundred eighteen patients completed the study. Patients in the preoperative group reported lower pain Numeric Ranking Scale values compared with those in the control group (net difference 2 points; 95% confidence interval [CI], 0.3-3.1 at 4hours, 1-3 at 6hours, and 0.7-3 at 24hours; p=.01) Patients in the preoperative group consumed significantly less morphine than did those in the control group (net difference 7mg; 95% CI, 0.7-13; p=.02). More patients who received nebulization walked without assistance within 12hours after awakening than did those in the instillation and control groups (net difference 15%; 95% CI, 6%-24%; p=.001). Conclusions: Cold nebulization of ropivacaine before surgery reduced postoperative pain and morphine consumption and was associated with earlier walking without assistance.

KW - Acute pain

KW - Anesthetic techniques

KW - Insufflation

KW - Local anesthetics

KW - Postoperative

KW - Regional analgesics

KW - Regional techniques

KW - Ropivacaine

UR - http://www.scopus.com/inward/record.url?scp=84908167120&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84908167120&partnerID=8YFLogxK

U2 - 10.1016/j.jmig.2014.03.021

DO - 10.1016/j.jmig.2014.03.021

M3 - Article

C2 - 24727030

AN - SCOPUS:84908167120

VL - 21

SP - 863

EP - 869

JO - Journal of Minimally Invasive Gynecology

JF - Journal of Minimally Invasive Gynecology

SN - 1553-4650

IS - 5

ER -