Jinhua Feng1, Ka Li2, Huan Feng1, Qiang Han1, Min Gao1, Ruihua Xu1. 1. Department of Bilary Surgery of West China Hospital, Sichuan University, Chengdu 610041, China. 2. West China Nursing College, Sichuan University, Chengdu 610041, China.
Abstract
OBJECTIVE: To explore the effect of local infiltration of ropivacaine combined with multimodal analgesia with parecoxib for perioperative pain management in patients undergoing pancreaticoduodenectomy. METHODS: This randomized controlled trial was conducted among 98 patients undergoing pancreaticoduodenectomy in the Department of Biliary Surgery of West China Hospital between March, 2017 and August, 2018. The patients were randomized to receive perioperative analgesia with local infiltration anesthesia with ropivacaine combined with multimodal analgesia with parecoxib (experimental group, n=50) or postoperative analgesia with dizosin (controlgroup, n=48). The regimens for intraoperative anesthesia and postoperative pain relief were identical in the two groups. The differences in NRS pain score, use of pain relief agents, the incidences of adverse reactions to analgesia and wound infection, and the time to first ambulation and first flatus passage after the operation were compared between the two groups. RESULTS: At 12, 24 h, 48 h, 72 h and 7 days after the operation, the patients in the experimental group had significantly lower NRS scores (P < 0.05) than those in the control group. The rate of use of rescue analgesics was significantly lower in the experimental group than in the control group (32% vs 66.67%, P < 0.05); the rate of tramadol hydrochloride use was also significantly lower in the experimental group (P < 0.05). Compared with those in the control group, the patients in the experimental group showed a significantly lower total incidence of adverse reactions (22% vs 54.17%, P < 0.05) as well as a lower incidence of nausea and vomiting (P < 0.05), an earlier time of first ambulation and first flatus passage after the operation (P < 0.05), and a shorter postoperative hospital stay (P < 0.05). CONCLUSIONS: In patients undergoing pancreaticoduodenectomy, local infiltration of ropivacaine combined with multimodal analgesia with ropivacaine can effectively relieve perioperative pain, reduce the use of relief analgesics, lower the incidence of adverse reactions, and promote the recovery after the surgery.
RCT Entities:
OBJECTIVE: To explore the effect of local infiltration of ropivacaine combined with multimodal analgesia with parecoxib for perioperative pain management in patients undergoing pancreaticoduodenectomy. METHODS: This randomized controlled trial was conducted among 98 patients undergoing pancreaticoduodenectomy in the Department of Biliary Surgery of West China Hospital between March, 2017 and August, 2018. The patients were randomized to receive perioperative analgesia with local infiltration anesthesia with ropivacaine combined with multimodal analgesia with parecoxib (experimental group, n=50) or postoperative analgesia with dizosin (control group, n=48). The regimens for intraoperative anesthesia and postoperative pain relief were identical in the two groups. The differences in NRS pain score, use of pain relief agents, the incidences of adverse reactions to analgesia and wound infection, and the time to first ambulation and first flatus passage after the operation were compared between the two groups. RESULTS: At 12, 24 h, 48 h, 72 h and 7 days after the operation, the patients in the experimental group had significantly lower NRS scores (P &lt; 0.05) than those in the control group. The rate of use of rescue analgesics was significantly lower in the experimental group than in the control group (32% vs 66.67%, P &lt; 0.05); the rate of tramadol hydrochloride use was also significantly lower in the experimental group (P &lt; 0.05). Compared with those in the control group, the patients in the experimental group showed a significantly lower total incidence of adverse reactions (22% vs 54.17%, P &lt; 0.05) as well as a lower incidence of nausea and vomiting (P &lt; 0.05), an earlier time of first ambulation and first flatus passage after the operation (P &lt; 0.05), and a shorter postoperative hospital stay (P &lt; 0.05). CONCLUSIONS: In patients undergoing pancreaticoduodenectomy, local infiltration of ropivacaine combined with multimodal analgesia with ropivacaine can effectively relieve perioperative pain, reduce the use of relief analgesics, lower the incidence of adverse reactions, and promote the recovery after the surgery.
Authors: Suveen Angraal; Sudhakar V Nuti; Frederick A Masoudi; James V Freeman; Karthik Murugiah; Nilay D Shah; Nihar R Desai; Isuru Ranasinghe; Yun Wang; Harlan M Krumholz Journal: Am J Med Date: 2019-05-09 Impact factor: 4.965
Authors: Mohammed Abu Hilal; Francesco Di Fabio; Abdallah Badran; Hani Alsaati; Hannah Clarke; Imogen Fecher; Thomas H Armstrong; Colin D Johnson; Neil W Pearce Journal: Pancreatology Date: 2012-12-02 Impact factor: 3.996