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Continuous wound infiltration with ropivacaine for analgesia after caesarean section: a randomised, placebo‐controlled trial
Author(s) -
REINIKAINEN M.,
SYVÄOJA S.,
HARA K.
Publication year - 2014
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12362
Subject(s) - medicine , ropivacaine , anesthesia , placebo , caesarean section , oxycodone , bolus (digestion) , ibuprofen , confidence interval , analgesic , surgery , pregnancy , opioid , alternative medicine , receptor , pathology , biology , pharmacology , genetics
Background We evaluated the analgesic effect of ropivacaine infiltration into the surgical wound after caesarean section. Methods In a double‐blind trial, 67 patients who were scheduled for caesarean section under spinal anaesthesia were randomly assigned to receive either 0.75% ropivacaine or placebo ( NaCl 0.9%) through a multi‐orifice catheter that was placed into the surgical wound, between the muscle fascia and the subcutaneous tissue. The study drug was administered as a bolus of 10 ml at the end of the operation, followed by an infusion at 2 ml/h for 48 h. All patients were also given paracetamol and ibuprofen. The primary outcome was the total amount of rescue oxycodone needed during the first 48 h post‐operatively. Secondary outcomes included pain and patient satisfaction scores. Analyses were according to intention to treat. Results The mean (± standard deviation) amount of oxycodone administered during the first 48 h was 47.5 ± 20.9 mg in the ropivacaine group and 57.8 ± 29.4 mg in the placebo group (95% confidence interval for the difference between means, −22.8–2.2 mg; P = 0.10). There were no differences between the groups in pain scores or in patient satisfaction scores. Conclusion Continuous wound infiltration with ropivacaine did not decrease the need for opioids and had no impact on pain scores or patient satisfaction after caesarean section.