Preoperative ropivacaine infiltration in breast surgery
Article first published online: 24 DEC 2001
Acta Anaesthesiologica Scandinavica
Volume 44, Issue 9, pages 1093–1098, October 2000
How to Cite
Johansson, A., Axelson, J., Ingvar, C., Luttropp, H.-H. and Lundberg, J. (2000), Preoperative ropivacaine infiltration in breast surgery. Acta Anaesthesiologica Scandinavica, 44: 1093–1098. doi: 10.1034/j.1399-6576.2000.440910.x
- Issue published online: 24 DEC 2001
- Article first published online: 24 DEC 2001
- Received 28 September 1999, accepted for publication 3 April 2000
- Anesthesia, wound infiltration;
- local anesthetics, ropivacaine;
- main measures, postoperative;
- pain, nausea and vomiting;
- surgery, breast;
- nursing, pain, nausea and vomiting
The aim of the study was to investigate whether preoperative infiltration with ropivacaine in conjunction with breast surgery improves postoperative pain management and attenuates postoperative nausea and vomiting.
Prospective, randomised, double-blind study, including 60 healthy women (ASA 1–2) allocated to one of two groups. Thirty patients were given 0.3 ml/kg saline in the operating field before surgery. Another 30 patients received a similar volume of ropivacaine 3.75 mg/ml. A visual analogue scale (0–100 mm) was used for evaluation of postoperative pain, nausea and vomiting. If the score was more than 30 mm at rest, the patients were given ketobemidone i.v. as treatment for postoperative pain, and dixyrazine i.v. against nausea and vomiting. The intra- and postoperative analgesic requirements and postoperative nausea and vomiting were registered.
Results: The intraoperative fentanyl consumption was similar in the saline group 81±22 μg vs 76±28 μg; (ns) in the ropivacaine group. The postoperative 24-h ketobemidone consumption was also similar to those treated with ropivacaine (4.2±2.6 mg vs 4.2±4.3 mg; ns). Postoperative nausea and vomiting (PONV) occurred with similar frequencies in both groups. The 24-h dixyrazine consumption was the same in the two groups (2.1±2.7 mg in the saline group compared to 2.4±2.8 mg in the ropivacaine group; ns). After 6 h recovery, 41% of all patients had experienced nausea and 20% vomiting.
Conclusion: We found no differences in postoperative pain management between 3.75 mg/ml ropivacaine and saline wound infiltration before breast surgery. The data show similar postoperative needs of analgesics and antiemetics with a similar frequency of PONV.