Department of Obstetri c s and Gyne c o l ogy, The Lady Davis Carme l M edi c a l Center affi l iated to the Te c hnion Institute of Te c hno l ogy M edi c a l S c hoo l , Haifa, Israe l .

STUDY OBJECTIVE: To eva l uate the effi c a c y of intraperitonea l nebu l ization of ropiva c aine on pain re l ief during and after gyne c o l ogi c l aparos c opi c pro c edures in c l uding a review of the l iterature. DESIGN: Doub l e-b l inded, randomized, c ontro l l ed, c l ini c a l tria l (C ana dian Task For c e c l assifi c ation I). SETTING: University hospita l ambu l atory gyne c oendos c opi c department. PATIENTS: Forty patients (20 patients in ea c h arm) undergoing e l e c tive gyne c o l ogi c same-day outpatient l aparos c opi c surgery in c l uding uni l atera l /bi l atera l sa l pingo-oophore c tomy or uni l atera l /bi l atera l ovarian c yste c tomy. INTERVENTIONS: The study group re c eived 10 mL of 1% ropiva c aine and the c ontro l group re c eived 10 mL of steri l e water by intraperitonea l nebu l ization. During surgery, vita l signs were re c orded and summarized. Postoperative l y patients were fo l l owed up for 24 hours in c l uding visua l ana l og s c a l e s c ores and ana l gesi c use. M EASURE M ENTS AND M AIN RESULTS: No signifi c ant differen c es existed between the groups during surgery and at the re c overy department in terms of arteria l b l ood pressure (p = .42) or heart rate (p = .60). Regarding postoperative ana l gesia, no differen c e existed between the groups in terms of morphine c onsumption (p = .52) or other ana l gesi c s (p = .53). No signifi c ant differen c e existed between the groups in postoperative visua l ana l og s c a l e s c ores in c l uding vis c era l , abdomina l wa l l , and shou l der pain during rest and during c ough at the different time frames (30, 60, and 120 minutes and 6 and 24 hours after surgery). CONCLUSION: Our study is the first to examine the effe c ts of intraperitonea l nebu l ization of ropiva c aine throughout l aparos c opi c gyne c o l ogi c pro c edures on patients undergoing genera l anesthesia. Nebu l ization of 100 mg of ropiva c aine under our spe c ifi c regimen of anesthesia does not improve patients' out c ome in terms of intraoperative and postoperative pain a l ong with c onsumption of ana l gesi c s. Further resear c h with other regimens is required.

P M ID: 18722968 [Pub M ed - in pro c ess]