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Intraperitoneal Ropivacaine Irrigation in Patients Undergoing Bariatric Surgery: a Prospective Randomized Clinical Trial

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Abstract

Background

Despite most bariatric procedures are actually performed by laparoscopic approach, management of postoperative pain remains a major challenge. The aim of this study was to analyze the analgesic effect of intraperitoneal ropivacaine infusion in patients undergoing bariatric surgery.

Methods

A prospective randomized clinical trial of all the patients undergoing laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) between January and November 2015 was performed. Patients were randomized to experimental (EG: those patients undergoing intraperitoneal ropivacain irrigation) and control groups (CG: those undergoing intraperitoneal irrigation with normal saline).

Results

One hundred ten patients were included, 83 LRYGB (75.5 %) and 27 LSG (24.5 %). Mean pain, as measured by VAS score, was 21.7 ± 14.5 mm in CG and 13.3 ± 10.9 mm in EG (p = 0.002). Morphine needs during the first 24 h postoperatively were 21.8 % in CG and 3.6 % in EG (p = 0.01). Early taking of fluids by mouth was possible 6 h after surgery in 76.4 % in EG vs 34.5 % in CG (p = 0.001). Early mobilization ability (6 h after surgery) was feasible in 72.7 % in EG and 32.7 % in CG (p = 0.001). Median hospital stay was 3 days (range 2–10 days) in CG and 2 days (2–7 days) in EG (p = 0.009).

Conclusions

The intraoperative peritoneal infusion with ropivacaine in patients undergoing bariatric surgery is associated with a reduction in postoperative pain, lower morphine needs, earlier mobilization and earlier oral intake of fluids after surgery, and a shorter hospital stay.

ClinicalTrials.gov Identifier: NCT02641288

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Authors and Affiliations

  1. University Hospital Rey Juan Carlos, Mostoles, Madrid, Spain

    Jaime Ruiz-Tovar, Juan Gonzalez, Alejandro Garcia, Consuelo Cruz, Sara Rivas, Montiel Jimenez, Carlos Ferrigni & Manuel Duran

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  1. Jaime Ruiz-Tovar
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  2. Juan Gonzalez
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  3. Alejandro Garcia
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  4. Consuelo Cruz
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  5. Sara Rivas
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  6. Montiel Jimenez
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  7. Carlos Ferrigni
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  8. Manuel Duran
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Corresponding author

Correspondence to Jaime Ruiz-Tovar.

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Conflict of interest

All authors declare that they have no conflict of interests in the preparation of this manuscript.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Statement of human rights

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

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Ruiz-Tovar, J., Gonzalez, J., Garcia, A. et al. Intraperitoneal Ropivacaine Irrigation in Patients Undergoing Bariatric Surgery: a Prospective Randomized Clinical Trial. OBES SURG 26, 2616–2621 (2016). https://doi.org/10.1007/s11695-016-2142-z

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  • DOI: https://doi.org/10.1007/s11695-016-2142-z

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