Postoperative analgesia after laparoscopic ovarian cyst resection: Double-blind multicenter randomized control trial comparing intraperitoneal nebulization and peritoneal instillation of ropivacaine

Stefano Scalia Catenacci, Federica Lovisari, Shuo Peng, Massimo Allegri, Marta Somaini, Luca Ghislanzoni, Massimiliano Greco, Valeria Rossini, Luca D'Andrea, Alessandro Buda, Mauro Signorelli, Antonio Pellegrino, Debora Sportiello, Dario Bugada, Pablo M. Ingelmo

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Study Objective: To compare the effects of local anesthetic intraperitoneal nebulization with intraperitoneal instillation during laparoscopic ovarian cystectomy on postoperative morphine consumption and pain. Design: Multicenter, randomized, case-control trial. Design Classification: Canadian Task Force Classification I. Setting: University hospitals in Italy. Patients: One hundred forty patients scheduled for laparoscopic ovarian cystectomy. Interventions: Patients were randomized to receive either nebulization of ropivacaine 150 mg before surgery or instillation of ropivacaine 150 mg before surgery. Nebulization was performed using the Aeroneb Pro device (Aerogen, Galway, Ireland). Measurements and Main Results: One hundred forty patients were enrolled, and 123 completed the study. There was no difference between the 2 groups in average morphine consumption (7.3 ± 7.5 mg in the nebulization group vs 9.2 ± 7.2 mg in the instillation group; p = .17). Eighty-two percent of patients in the nebulization group required morphine compared with 96% in the instillation group (p <.05). Patients receiving nebulization had a lower dynamic Numeric Ranking Scale compared with those in the instillation group in the postanesthesia care unit postanesthesia care unit and 4 hours after surgery (p <.05). Ten patients (15%) in the nebulization group experienced shivering in the postanesthesia care unit compared with 2 patients (4%) in the instillation group (p = .035). Conclusion: Nebulization of ropivacaine prevents the use of morphine in a significant proportion of patients, reduced postoperative pain during the first hours after surgery, and was associated with a higher incidence of postoperative shivering when compared with instillation.

Original languageEnglish
Pages (from-to)759-766
Number of pages8
JournalJournal of Minimally Invasive Gynecology
Volume22
Issue number5
DOIs
Publication statusPublished - 2015

Fingerprint

Ovarian Cysts
Analgesia
Morphine
Shivering
Cystectomy
ropivacaine
Advisory Committees
Postoperative Pain
Local Anesthetics
Ireland
Italy
Pain
Equipment and Supplies

Keywords

  • Acute pain
  • Analgesics
  • Anesthetic techniques
  • Anesthetic techniques
  • Insuffiation
  • Local anesthetics
  • Postoperative
  • Regional
  • Regional techniques
  • Ropivacaine

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Medicine(all)

Cite this

Postoperative analgesia after laparoscopic ovarian cyst resection : Double-blind multicenter randomized control trial comparing intraperitoneal nebulization and peritoneal instillation of ropivacaine. / Catenacci, Stefano Scalia; Lovisari, Federica; Peng, Shuo; Allegri, Massimo; Somaini, Marta; Ghislanzoni, Luca; Greco, Massimiliano; Rossini, Valeria; D'Andrea, Luca; Buda, Alessandro; Signorelli, Mauro; Pellegrino, Antonio; Sportiello, Debora; Bugada, Dario; Ingelmo, Pablo M.

In: Journal of Minimally Invasive Gynecology, Vol. 22, No. 5, 2015, p. 759-766.

Research output: Contribution to journalArticle

Catenacci, Stefano Scalia ; Lovisari, Federica ; Peng, Shuo ; Allegri, Massimo ; Somaini, Marta ; Ghislanzoni, Luca ; Greco, Massimiliano ; Rossini, Valeria ; D'Andrea, Luca ; Buda, Alessandro ; Signorelli, Mauro ; Pellegrino, Antonio ; Sportiello, Debora ; Bugada, Dario ; Ingelmo, Pablo M. / Postoperative analgesia after laparoscopic ovarian cyst resection : Double-blind multicenter randomized control trial comparing intraperitoneal nebulization and peritoneal instillation of ropivacaine. In: Journal of Minimally Invasive Gynecology. 2015 ; Vol. 22, No. 5. pp. 759-766.
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abstract = "Study Objective: To compare the effects of local anesthetic intraperitoneal nebulization with intraperitoneal instillation during laparoscopic ovarian cystectomy on postoperative morphine consumption and pain. Design: Multicenter, randomized, case-control trial. Design Classification: Canadian Task Force Classification I. Setting: University hospitals in Italy. Patients: One hundred forty patients scheduled for laparoscopic ovarian cystectomy. Interventions: Patients were randomized to receive either nebulization of ropivacaine 150 mg before surgery or instillation of ropivacaine 150 mg before surgery. Nebulization was performed using the Aeroneb Pro device (Aerogen, Galway, Ireland). Measurements and Main Results: One hundred forty patients were enrolled, and 123 completed the study. There was no difference between the 2 groups in average morphine consumption (7.3 ± 7.5 mg in the nebulization group vs 9.2 ± 7.2 mg in the instillation group; p = .17). Eighty-two percent of patients in the nebulization group required morphine compared with 96{\%} in the instillation group (p <.05). Patients receiving nebulization had a lower dynamic Numeric Ranking Scale compared with those in the instillation group in the postanesthesia care unit postanesthesia care unit and 4 hours after surgery (p <.05). Ten patients (15{\%}) in the nebulization group experienced shivering in the postanesthesia care unit compared with 2 patients (4{\%}) in the instillation group (p = .035). Conclusion: Nebulization of ropivacaine prevents the use of morphine in a significant proportion of patients, reduced postoperative pain during the first hours after surgery, and was associated with a higher incidence of postoperative shivering when compared with instillation.",
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AU - Catenacci, Stefano Scalia

AU - Lovisari, Federica

AU - Peng, Shuo

AU - Allegri, Massimo

AU - Somaini, Marta

AU - Ghislanzoni, Luca

AU - Greco, Massimiliano

AU - Rossini, Valeria

AU - D'Andrea, Luca

AU - Buda, Alessandro

AU - Signorelli, Mauro

AU - Pellegrino, Antonio

AU - Sportiello, Debora

AU - Bugada, Dario

AU - Ingelmo, Pablo M.

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N2 - Study Objective: To compare the effects of local anesthetic intraperitoneal nebulization with intraperitoneal instillation during laparoscopic ovarian cystectomy on postoperative morphine consumption and pain. Design: Multicenter, randomized, case-control trial. Design Classification: Canadian Task Force Classification I. Setting: University hospitals in Italy. Patients: One hundred forty patients scheduled for laparoscopic ovarian cystectomy. Interventions: Patients were randomized to receive either nebulization of ropivacaine 150 mg before surgery or instillation of ropivacaine 150 mg before surgery. Nebulization was performed using the Aeroneb Pro device (Aerogen, Galway, Ireland). Measurements and Main Results: One hundred forty patients were enrolled, and 123 completed the study. There was no difference between the 2 groups in average morphine consumption (7.3 ± 7.5 mg in the nebulization group vs 9.2 ± 7.2 mg in the instillation group; p = .17). Eighty-two percent of patients in the nebulization group required morphine compared with 96% in the instillation group (p <.05). Patients receiving nebulization had a lower dynamic Numeric Ranking Scale compared with those in the instillation group in the postanesthesia care unit postanesthesia care unit and 4 hours after surgery (p <.05). Ten patients (15%) in the nebulization group experienced shivering in the postanesthesia care unit compared with 2 patients (4%) in the instillation group (p = .035). Conclusion: Nebulization of ropivacaine prevents the use of morphine in a significant proportion of patients, reduced postoperative pain during the first hours after surgery, and was associated with a higher incidence of postoperative shivering when compared with instillation.

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KW - Regional techniques

KW - Ropivacaine

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