Advanced

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

Johansson, Anders LU ; Kornfalt, J; Nordin, L; Svensson, L; Ingvar, Christian LU and Lundberg, Johan LU (2003) In Journal of Clinical Anesthesia 15(2). p.113-118
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 mug/kg; and intravenous (IV) fentanyl 0.5 mug/kg before skin incision and no wound infiltration. Time to first... (More)
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. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
local anesthetics, anesthetic technique, wound infiltration
in
Journal of Clinical Anesthesia
volume
15
issue
2
pages
113 - 118
publisher
Elsevier
external identifiers
  • pmid:12719050
  • wos:000182714900006
  • scopus:0037359972
ISSN
1873-4529
DOI
10.1016/S0952-8180(02)00511-1
language
English
LU publication?
yes
id
c3ed95b3-f48f-4003-8ef5-303f453b38ba (old id 312035)
date added to LUP
2007-09-13 14:01:58
date last changed
2018-08-19 03:34:12
@article{c3ed95b3-f48f-4003-8ef5-303f453b38ba,
  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 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 &lt; 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.},
  author       = {Johansson, Anders and Kornfalt, J and Nordin, L and Svensson, L and Ingvar, Christian and Lundberg, Johan},
  issn         = {1873-4529},
  keyword      = {local anesthetics,anesthetic technique,wound infiltration},
  language     = {eng},
  number       = {2},
  pages        = {113--118},
  publisher    = {Elsevier},
  series       = {Journal of Clinical Anesthesia},
  title        = {Wound infiltration with ropivacaine and fentanyl: Effects on postoperative pain and PONV after breast surgery},
  url          = {http://dx.doi.org/10.1016/S0952-8180(02)00511-1},
  volume       = {15},
  year         = {2003},
}