Analysis on efficacy of local incision continuous local ropivacine infiltration anesthetic analgesia after total knee arthroplasty / 重庆医学

Objective To investigate and evaluate the effectiveness and safety of continuous local incision infiltration anesthetic analgesia after total knee arthroplasty(TKA).Methods Forty-eight patients with initial unilateral TKA in the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University from August 2015 to May 2016 were allocated to three groups according to systematic random sampling methods:16 cases in the control group received continuous local incision infiltration anesthesia and femoral nerve block analgesia,16 cases received continuous femoral nerve block analgesia after TKA(CFNB) and other 16 cases received local ropivacaine continuous local incision infiltration anesthesia analgesia(CWI).The preoperative general situation,visual analogue scale (VAS) score of operative site in movement and rest on postoperative 1-3 d,postoperative early function recovery and postoperative complication were compared among 3 groups.Results All cases were followed up.There was no statistically significant difference in the general situation postoperative complications among 3 groups(P＞0.05).the VAS score under movement status on postoperative 1-3 d and rest status in the CWI group and CFNB group were similar,which were lower than those in the control group,the difference was statistically significant(P＜0.05);the postoperative early function recovery in the CWI group was superior to that in the control group and CFNB group.Conclusion local incision infiltration anesthetic analgesia after TKA can relief postoperative pain,facilitate patient's early function exercise and rehabilitation,and improves patient's satisfaction.

Ropivacaine wound infiltration:a fast-track approach in patients with hepatocellular carcinoma undergo-ing open hepatectomy / 临床麻醉学杂志

Objective To investigate the effectiveness and safety of wound infiltration with rop-ivacaine for postoperative analgesia as a fast-track approach in patients undergoing open hepatectomy. Methods Fifty-two patients with hepatocellular carcinoma,32 males,20 females,aged 18-70 years, scheduled for selective open hepatectomy were enrolled in this trible-blind,randomized,controlled study.Patients were randomized to receive 0.75% ropivacaine (group ROP)or 0.9% normal saline (group NS)wound infiltration before incision closures at a total volume of 10 ml.Numerical rating score (NRS)at 6,12,24 and 48 hours after surgery,length of hospital stay,time to bowel recovery,ambulation and drainage tube extraction were recorded.Side effects, including post-operative liver and renal function,allergic reaction,nausea and vomiting,and wound infection,were also assessed.Results NRS was significantly decreased at 6 [(3.85±1.29)scores vs.(5.30±1.76) scores],12 [(3.38±0.85)scores vs.(5.69 ±1.38)scores]and 24 hours [(3.69 ±0.74)scores vs. (4.42±1.13)scores]after surgery in group ROP compared to group NS (P <0.05).Group ROP al-so showed shorter postoperative hospital stays [(1 7.92±1.97)d vs.(1 9.53±2.42)d],earlier anal exsufflation [(48.07±7.49)h vs.(53.42±10.38)h]and ambulation [(2.34±0.62)d vs.(2.80± 0.84)d](P <0.05).However,there were no significant differences between the two groups in re-garding post-operative liver and renal function.The incidence of nausea and vomiting was 1 5% (4 ca-ses)and 1 9%(5 cases)in group NS and group ROP,respectively.No allergic reactions occurred in either group.Conclusion The present study shows that ropivacaine wound infiltration could effectively release post-operative pain,and could be a safe and effective fast-track approach for patients undergoing open hepatectomy.

Custo-efetividade da infiltração contínua da ferida cirúrgica com ropivacaína versus morfina para controle de dor aguda / Cost-effectiveness of ropivacaine continuous wound infiltration versus morphine for acute pain control

OBJETIVOS: Avaliar a custo-efetividade da infiltração contínua da ferida cirúrgica (ICFC) com ropivacaína versus infusão de morfina, sob a perspectiva da Saúde Suplementar Brasileira, em horizonte de 48 horas após cirurgias de grande porte. MÉTODOS: Análise de custo-efetividade por modelo analítico de decisão, empregando dados clínicos de sucesso de analgesia e redução de efeitos colaterais, como náuseas e vômitos pós-operatórios ligados à analgesia com opioides (PONV), obtidos por revisão de literatura. Foram considerados no modelo custos médicos diretos e custos relacionados à internação (receita líquida por leito). RESULTADOS: A eficácia clínica da tecnologia de ICFC mostrou-se superior em todos os cenários apresentados, quando comparada à morfina endovenosa, com menor incidência de PONV, maior taxa de sucesso da analgesia e menor necessidade de opioides de resgate. Ainda, a ICFC mostrou-se menos dispendiosa do que o comparador selecionado, seja administrado por infusão em bolus ou por dispositivo de infusão de fármacos. O resultadose deve, majoritariamente, à redução do tempo de permanência hospitalar. CONCLUSÃO: A ICFC é uma alternativa extremamente efetiva, do ponto de vista clínico, para controle de dor aguda. A tecnologia pode trazer ainda economia de recursos financeiros em curto prazo, já que a dor aguda ea incidência de PONV, além de aumentar o consumo de medicamentos, como opioides e antieméticos, pode prolongar a recuperação do paciente e a sua permanência hospitalar.

OBJECTIVES: To assess cost-effectiveness of continuous wound infiltration (CWI) with ropivacaine versus intravenous morphine, under the perspective of the Brazilian Supplementary Health System, in a time horizon of 48 hours after major surgeries. METHODS: Cost-effectiveness analysis through an analytic decision model, applying clinical data of success rate of analgesia and reduction of side effects, such as opioid related postoperative nausea and vomiting (PONV), obtained through literature review. The model accomplishes direct medical costs and costs related to hospital stay (incomeper hospital bed). RESULTS: Clinical efficacy of CWI has shown superior results in all scenarios presented, when compared to intravenous morphine, with lower incidence of PONV, higher success rates in analgesia and less need of rescue with opioids. CWI has also shown less expensive than the selected comparator administered either in bolus or drug infusion devices. This result is specially derived from the reduction on the hospital length of stay. CONCLUSION: CWI is an extremely effective alternative for acute pain control, in the clinical point of view. It can also generate cost-savings in the short term, as acute pain and PONV incidence, besides increasing consumption of opioids and antiemetic drugs, can jeopardize patient recovery and prolong unnecessarily his hospital stay.

Wound Infiltration in Patients with Chronic Pain after Forehead Lift Surgery: A case report / 대한통증학회지

Local infiltration in surgical wounds can reduce postoperative pain with very few side effects. We experienced two cases of chronic pain after forehead lift surgery. A 41-year-old male patient was suffering from a headache at the crown of the head and pain from the posterior neck. A 54-year-old female patient had pain around the forehead, worsened by psychological stress. They underwent forehead lift surgery 10 years and 8 months ago, respectively. Conservative treatments such as medication and physical therapy were not effective. After wound infiltration with 1% lidocaine more than ten times, pain significantly resolved in both patients.

Efficacy of wound infiltration with ropivacaine on postoperative pain relief after acute appendectomy in children / 中国临床药理学与治疗学

0.05) except during the 24 th hour postoperative period.During the 0.5 h postoperative period,the average total amount of injections of morphine was statistically lower in the ropivacaine group(control 15.8?23.9 ?g/kg versus ropivacaine 2.4?10.9 ?g/kg;P