Effectiveness of continuous wound infusion of 0.5% ropivacaine by On-Q pain relief system for postoperative pain management after open nephrectomy

doi:10.1093/bja/aen309

British Journal of Anaesthesia 2008 101(6):841-847; doi:10.1093/bja/aen309

This Article

	Full Text
	Full Text (PDF)
	E-Letters: Submit a response to the article
	E-letters: View responses
	Alert me when this article is cited
	Alert me when E-letters are posted
	Alert me if a correction is posted

Services

	Email this article to a friend
	Related articles in BJA
	Similar articles in this journal
	Similar articles in PubMed
	Alert me to new issues of the journal
	Add to My Personal Archive
	Download to citation manager
	Request Permissions
	Disclaimer

Google Scholar

	Articles by Forastiere, E.
	Articles by Simone, G.
	Search for Related Content

PubMed

	PubMed Citation
	Articles by Forastiere, E.
	Articles by Simone, G.

Social Bookmarking

	What's this?

Effectiveness of continuous wound infusion of 0.5% ropivacaine by On-Q pain relief system for postoperative pain management after open nephrectomy

E. Forastiere¹^,*, M. Sofra¹, D. Giannarelli², L. Fabrizi¹ and G. Simone³

¹ Department of Anesthesiology
² Department of Biostatistics
³ Department of Urology, ‘Regina Elena’ National Cancer Institute of Rome, Via Elio Chianesi 53, Italy

^* Corresponding author. E-mail: puldet{at}gmail.com

Background: Block of parietal nociceptive afferent nerves using continuouswound infiltration with local anaesthetics may be beneficialin multimodal postoperative pain management. The effectivenessof continuous wound infusion of ropivacaine for postoperativepain relief after open nephrectomy was analysed in a prospective,randomized, double-blinded, placebo-controlled trial.

Methods: One hundred and sixty-eight patients were randomized to either0.5% ropivacaine (ON-Q group) or 0.9% NaCl (control group),using an elastomeric pump which delivered 4 ml h^–1 over48 h through two multiholed Soaker^® catheters placed betweenthe transverse and the internal oblique muscles and the s.c.space. All patients received a standard postoperative pain managementprotocol, including patient-controlled analgesic morphine andketorolac. Outcomes measured over 48 h after operation werevisual analogue scale (VAS) and incident (i) VAS pain scores,morphine consumption, and side-effects; time to bowel functionrecovery; and mean length of hospitalization.

Results: Side-effects were similar between the two groups. VAS and i-VASpain scores, morphine consumption [11.5 (0.27) vs 21.8 (0.37)mg; P<0.001], time to bowel recovery [21.8 (0.4) vs 33.6(0.9) h; P<0.001], and mean length of hospitalization [2.1(0.03) vs 3.2 (0.1) days; P<0.001] were significantly reducedin the ON-Q group. Cost analysis revealed an overall savingsof $~$ 273 euros per patient in the ON-Q group.

Conclusions: Continuous surgical wound infusion with ropivacaine improvedpain relief and accelerated recovery and discharge reducingoverall costs of care.

Keywords: anaesthetics local, ropivacaine; pain, postoperative; surgery, urological

Add to CiteULike CiteULike Add to Connotea Connotea Add to Del.icio.us Del.icio.us What's this?

Related articles in BJA:

In the December 2008 BJA...: BJA 2008 101: NP. [Extract] [Full Text]

This article has been cited by other articles:

R. Harish, E. Forastiere, and M. Sofra
Low-dose infusion with 'surgical transverse abdominis plane (TAP) block' in open nephrectomy
Br. J. Anaesth., June 1, 2009; 102(6): 889 - 890.
[Full Text] [PDF]

E-letters:

Read all E-letters

Low dose infusion with "Surgical TAP block" in open nephrectomy: Rav Harish; British Journal of Anaesthesia, 13 Mar 2009 [Full text]
REPLY: Ester Forastiere, et al.; British Journal of Anaesthesia, 7 Apr 2009 [Full text]