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Am J Surg ; 215(1): 138-143, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-28958651

RESUMEN

BACKGROUND: Surgical wound is source of pain in hepatectomy with laparotomy. Continuous wound infusion of ropivacaine may provide effective analgesia. METHODS: This prospective, randomized trial, patients scheduled for hepatectomy received a 48-h preperitoneal continuous wound infusion of either 0.23% ropivacaine or 0.9% saline at 5 ml/h. Primary endpoint was 48 h morphine consumption. RESULTS: 53 patients included in the ropivacaine group and 46 in the saline group. Morphine consumption was 24.63 mg in the ropivacaine group, and 26.78 mg (p = 0.669) in the saline group. Pain was comparable between groups and there were no differences in solid food intake, ambulation, or length of hospital stay. No local or systemic complications were recorded. CONCLUSIONS: Continuous wound infusion with ropivacaine is safe, but it neither reduced morphine consumption nor enhanced recovery in patients undergoing hepatectomy. Success of enhanced recovery in hepatectomy is not influenced by the analgesic regimen if pain is well controlled.


Asunto(s)
Amidas , Anestesia Local/métodos , Anestésicos Locales , Hepatectomía , Dolor Postoperatorio/prevención & control , Cuidados Posoperatorios/métodos , Cloruro de Sodio , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Analgésicos Opioides/uso terapéutico , Método Doble Ciego , Femenino , Humanos , Infusiones Intralesiones , Masculino , Persona de Mediana Edad , Morfina/uso terapéutico , Dimensión del Dolor , Dolor Postoperatorio/diagnóstico , Dolor Postoperatorio/tratamiento farmacológico , Estudios Prospectivos , Ropivacaína , Resultado del Tratamiento , Adulto Joven
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