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

Abstract：

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 microg/kg; and intravenous (i.v.) fentanyl 0.5 microg/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 i.v. 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 i.v. 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 i.v. fentanyl.

journal_name

J Clin Anesth

journal_title

Journal of clinical anesthesia

authors

Johansson A,Kornfält J,Nordin L,Svensson L,Ingvar C,Lundberg J

doi

10.1016/s0952-8180(02)00511-1

subject

Has Abstract

pub_date

2003-03-01 00:00:00

pages

113-8

issue

2

eissn

0952-8180

issn

1873-4529

pii

S0952818002005111

journal_volume

15

pub_type

临床试验,杂志文章,随机对照试验

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