Randomized trial of subfascial infusion of ropivacaine for early recovery in laparoscopic colorectal cancer surgery

Korean Journal of Anesthesiology 2016년 69권 6호 p.604 ~ p.613

이상현(Lee Sang-Hyun) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Anesthesiology and Pain Medicine
심우석(Sim Woo-Seog) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Anesthesiology and Pain Medicine
김고은(Kim Go-Eun) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Anesthesiology and Pain Medicine
김희철(Kim Hee-Cheol) - Sungkyunkwan University School of Medicine Samsung Medical Center Division of Colorectal Surgery
전주현(Jun Joo-Hyun) - Hallym University College of Medicine Kangnam Sacred Heart Hospital Department of Anesthesiology and Pain Medicine
이진영(Lee Jin-Young) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Anesthesiology and Pain Medicine
신병섭(Shin Byung-Seop) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Anesthesiology and Pain Medicine
유희진(Yoo Hee-Jin) - Samsung Medical Center Biostatistics and Clinical Epidemiology Center
(Jung Sin-Ho) - Samsung Medical Center Biostatistics and Clinical Epidemiology Center
김정연(Kim Joung-Youn) - Chungbuk National University Department of Information Statistics
이승현(Lee Seung-Hyeon) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Anesthesiology and Pain Medicine
(Yo Deok-Kyu) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Anesthesiology and Pain Medicine
(Na Yu-Ri) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Anesthesiology and Pain Medicine

Abstract

Background : There is a need for investigating the analgesic method as part of early recovery after surgery tailored for laparoscopic colorectal cancer (LCRC) surgery. In this randomized trial, we aimed to investigate the analgesic efficacy of an inverse ‘v’ shaped bilateral, subfascial ropivacaine continuous infusion in LCRC surgery.

Methods : Forty two patients undergoing elective LCRC surgery were randomly allocated to one of two groups to receive either 0.5% ropivacaine continuous infusion at the subfascial plane (n = 20, R group) or fentanyl intravenous patient controlled analgesia (IV PCA) (n = 22, F group) for postoperative 72 hours. The primary endpoint was the visual analogue scores (VAS) when coughing at postoperative 24 hours. Secondary end points were the VAS at 1, 6, 48, and 72 hours, time to first flatus, time to first rescue meperidine requirement, rescue meperidine consumption, length of hospital stay, postoperative nausea and vomiting, sedation, hypotension, dizziness, headache, and wound complications.

Results : The VAS at rest and when coughing were similar between the groups throughout the study. The time to first gas passage and time to first rescue meperidine at ward were significantly shorter in the R group compared to the F group (P = 0.010). Rescue meperidine was administered less in the R group; however, without statistical significance. Other study parameters were not different between the groups.

Conclusions : Ropivacaine continuous infusion with an inverse ‘v ’ shaped bilateral, subfascial catheter placement showed significantly enhanced bowel recovery and analgesic efficacy was not different from IV PCA in LCRC surgery.

키워드

Analgesia, Colorectal surgery, Laparoscopy, Local anesthetics, Ropivacaine, Subfascia
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MEDLINE 학술진흥재단(KCI) KoreaMed 대한의학회 회원 
주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
Subfascial infusion of ropivacaine analgesic efficacy was not different from IV PCA in laparoscopic colorectal cancer (LCRC) surgery; Ropivacaine continuous infusion with an inverse “v” shaped bilateral, subfascial catheter placement showed significantly enhanced bowel recovery.
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