López-Maya L, Lina-Manjarrez F, Díaz-Peralta A, Lina-López LM

Language: Spanish
References: 25
Page: 251-259
PDF size: 116.72 Kb.

ABSTRACT

Laparoscopic cholecystectomy postoperative pain is minor compared to the open cholecystectomy, but effective analgesic treatment still is controversial and remains unchanged. The aim of this study was to demonstrate that with the administration of ropivacaine to 7.5%, allows to reduce the intensity of operative pain in patients undergoing laparoscopic cholecystectomy. Material and methods: Was a controlled clinical trial, randomized, comparative, double-blind. Included 124 patients scheduled for laparoscopic cholecystectomy, which were assigned to 2 groups: Group 1: patients receiving with ropivacaine to 7.5% before the incision in the skin and start of partial pneumoperitoneum and Group 2: After incision and at the end of the total pneumoperitoneum. The registration of pain intensity was made with the visual analog escale to enter the recovery room, 1, 2, 3 and 24 h with modified the questionnaire McGill. Results: The dates were analyzed using the Student’s t test and Kruskall Wallis. In the EVA 0 was obtained in 0.0216 and EVA 1, 2, 3 and 4 at p ‹ of 0.05 with statistical significance. McGill scale obtained on average 4 ± 3.48 for Group 1 vs 8 ± 4.57 in Group 2 with p ‹ 0.011. Conclusions: The ropivacaine to 7.5% administered before the skin and affect the onset of partial pneumoperitoneum decreases postoperative pain after colecystectomy laparoscopic.

REFERENCES

1. Archivos del Quirófano del HGZ y MF Núm. 76, Xalostoc Estado de México.

2. Settecase C, Bagilet D. El diclofenaco preoperatorio no reduce el dolor de la colecistectomía laparoscópica. Rev Esp An 2002;49:455-60.

3. Steen M. Local anesthetic infiltration for postoperative pain relief after Laparoscopy. Anesth Analg 2000;90:899-912.

4. Thue B. Analgesic Treatment after laparoscopic cholecystectomy. A critical assessment of the evidence. Anesthesiology 2006;104:835-46.

5. Gottschalk A. New concepts in acute pain therapy: preemptive analgesia. American Family Physician 2001;63:1979-84.

6. Gordillo-Álvarez V. Manejo perioperatorio del dolor en el paciente pediátrico. Rev Mex Anest 2006;29:204-206.

7. Eliezer K. Preemptive Analgesia and local anesthesia as a supplement to general anesthesia: a review. Anesth Prog 2005;52:29-38.

8. Michaloliakou C. Preoperative multimodal Analgesia Facilitates Recovery after Ambulatory Laparoscopic. Anesth Analg 1996;82:44-51.

9. Ortiz de la Peña RJ. Analgesia Multimodal en cirugía laparoscópica. Asociación Mexicana de Cirugía Endoscópica. 2003;4:120-33.

10. Reyes-Fierro A. Dolor postoperatorio: Analgesia Multimodal. Patología del Aparato Locomotor 2004;23:176-88.

11. Thue B. Multi-regional local anesthetic infiltration during laparoscopic cholecystectomy in patients receiving prophylactic multi-modal analgesia. Anesth Analg 1999;89:1017-24.

12. Granadillo E. Premediación con ketorolaco para analgesia postoperatoria para cirugía ginecológica. Archivos Venezolanos de Farmacología y terapéutica. 2001;20:69-79.

13. Labrada E. Analgesia multimodal preventiva: estudio comparativo. Revista de la Sociedad Española del Dolor 2004;11:12-28.

14. Lobarde MD. The clinical efficacy and pharmacokinetics of intraperitoneal ropivacaine for laproscopic cholecystectomy. Anesth Analg 2002; 94:100-5.

15. Marrón-Peña M. Ropivacaína neuroaxial para operación cesárea. Revista Mexicana de Anestesiología 2008;31:133-38.

16. Guevara-López U. Parámetros de práctica para el manejo del dolor en México. Cir Ciruj 2007;75:385-405.

17. Pardo C, Muñoz T. Monitorización del dolor, recomendaciones del grupo de trabajo de analgesia y sedación de la SEMICYUC. Med Intensiva 2006;30:379-85.

18. Serrano MS. Valoración del dolor. Rev Soc Esp Dolor 2002;9:94-108.

19. Caseras LX. Medida del dolor postoperatorio: análisis de la sensibilidad de diversos instrumentos de autovaloración. Rev Esp Anestesiol Reanim 2003;50:230-36.

20. Hulley SB. Estimación del tamaño de muestra y de la potencia. Diseño de la Investigación Clínica. Ed. Doyma 1993:155-165.

21. Méndez-Ramírez I. El protocolo de Investigación. Lineamientos para su elaboración y análisis. México., Ed. Trillas 1991:1-61,111-85.

22. Castañeda-Jiménez J. Metodología de la investigación. México McGraw Hill México 2005.

23. Rincón GA. Reducción del dolor del hombro en ginecología laparoscópica. Revista de Obstetricia y Ginecología de Venezuela 2004;64:183-87.

24. Carmona J. Efecto analgésico de la bupivacaína intraperitoneal en colecistectomía laparoscópica. Estudio prospectivo, aleatorio con placebo. Rev Venez Cir 2008;61:114-18.

25. Yu-Yin L, Chun-Nan Y. Local Anesthesia with ropivacaine for patients undergoing laparoscopic cholecystectomy. World J. Gastroenterol 2009;15: 2376-80.