Comparing the effectiveness of ropivacaine 0.5% versus ropivacaine 0.2% for transabdominis plane block in providing postoperative analgesia after appendectomy

Jalil, Reymi Marseela Abdul; Yahya, Nurlia; Sulaiman, Omar; Mat, Wan Rahiza Wan; Teo, Rufinah; Izaham, Azarinah; Rahman, Raha Abdul

doi:10.1016/j.aat.2014.05.007

Cited by 21 publications

(13 citation statements)

References 21 publications

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“…With a vasoconstrictive effect at low concentration (0.063-0.5%) 34 , ropivacaine is often not used with epinephrine 7 which also has an unpredictable role in the cardiovascular system. The concentrations of ropivacaine in this study were chosen to be 0.2%, 0.33%, 0.5% based on the findings that scalp infiltration by 0.5% ropivacaine reduced postoperative pain received craniotomy in previous study 17 and 0.2%, 0.33% ropivacaine are usually preferred for peripheral nerve block procedures [35][36][37] . In our study, pre-incision SNB with 0.2% and 0.33% ropivacaine decreased the postoperative pain for up to 2 hours, and 0.5% ropivacaine used as postoperative analgesia had longer duration for up to 4 hours after craniotomy.…”

Section: Discussionmentioning

confidence: 99%

Effect of Scalp Nerve Block with Ropivacaine on Postoperative Pain in Patients Undergoing Craniotomy: A Randomized, Double Blinded Study

Yang

Zhou

et al. 2020

Sci Rep

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Scalp nerve block with ropivacaine has been shown to provide perioperative analgesia. However, the best concentration of ropivacaine is still unknown for optimal analgesic effects. We performed a prospective study to evaluate the effects of scalp nerve block with varied concentration of ropivacaine on postoperative pain and intraoperative hemodynamic variables in patients undergoing craniotomy under general anesthesia. Eighty-five patients were randomly assigned to receive scalp block with either 0.2% ropivacaine, 0.33% ropivacaine, 0.5% ropivacaine, or normal saline. Intraoperative hemodynamics and post-operative pain scores at 2, 4, 6, 24 hours postoperatively were recorded. We found that scalp blockage with 0.2% and 0.33% ropivacaine provided adequate postoperative pain relief up to 2 h, while administration of 0.5% ropivacaine had a longer duration of action (up to 4 hour after craniotomy). Scalp nerve block with varied concentration of ropivacaine blunted the increase of mean arterial pressure in response to noxious stimuli during incision, drilling, and sawing skull bone. 0.2% and 0.5% ropivacaine decreased heart rate response to incision and drilling. We concluded that scalp block using 0.5% ropivacaine obtain preferable postoperative analgesia compared to lower concentrations. And scalp block with ropivacaine also reduced hemodynamic fluctuations in craniotomy operations. About 10% to 20% patients undergoing craniotomy suffered severe pain and more than 30% experienced moderate pain as per Guilfoyle et al. 1. These experiences with pain may disturb patient sleep patterns and prolong hospital stays 2. Abrupt increases in heart rate (HR) and blood pressure (BP) resulting from dramatic stimuli like incisions, drilling, and screwing cause potential morbidities and mortalities due to elevation of intracranial pressure (ICP) in patients 3,4. Generally, opioids are used for relieving hemodynamic fluctuations and reducing postoperative pain, however, it may delay recovery time, contribute to extreme sedation, and interfere with postoperative neurological examinations. In addition, adverse effects of opioids such as nausea and vomiting, and respiratory depression may result in a rise of ICP or mask the signs of increased ICP. Since there is such an emphasis on controlling the adverse effects of opioid administration, postoperative pain after craniotomy is frequently uncontrolled 1. Easing hemodynamic perturbation and relieving postoperative pain are important concerns of neuroanesthesiologists and are also necessary components of the Enhanced Recovery After Surgery (ERAS). With advances in modern anesthesia come the development of short-acting analgesics, mainly remifentanil, transition analgesics, and conjunction analgesics that can be used instead of opioids to treat postoperative pain 5. Scalp never block (SNB), the blockage of nerves that innervate the involved region of the scalp about surgery 6 , was developed due to its potential benefits for effective regional anesthesia administration 7 , which promotes d...

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Section: Discussionmentioning

confidence: 99%

Effect of Scalp Nerve Block with Ropivacaine on Postoperative Pain in Patients Undergoing Craniotomy: A Randomized, Double Blinded Study

Yang

Zhou

et al. 2020

Sci Rep

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“…Though we preferred to use intravenous paracetamol as sole rescue analgesic in the present study as compared to opioid analgesics, the overall cumulative analgesic consumption with either of the local anesthetic in both the groups was less and comparable to studies that have used opioids for postoperative analgesia by the use of these local anesthetics in other peripheral blocks. [ 16 24 25 ] In addition, by using paracetamol as rescue analgesic, the unwarranted side effects of opioids were also avoided. The rescue analgesic was administered only if VAS exceeded 40.…”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of ropivacaine and levobupivacaine for postoperative analgesia after ultrasound-guided paravertebral block in patients undergoing percutaneous nephrolithotomy

Saroa

Palta

Puri

et al. 2018

J Anaesthesiol Clin Pharmacol

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“…Recently positive results have been published regarding the pre-emptive incision site infiltration with a local anaesthetic. Studies demonstrated that this decreases the total opioid consumption and lowers pain score experienced by patients in the first 24 h after surgery [182–184]. …”

Section: Post-operative Carementioning

confidence: 99%

Diagnosis and management of acute appendicitis. EAES consensus development conference 2015

et al. 2016

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Unequivocal international guidelines regarding the diagnosis and management of patients with acute appendicitis are lacking. The aim of the consensus meeting 2015 of the EAES was to generate a European guideline based on best available evidence and expert opinions of a panel of EAES members. After a systematic review of the literature by an international group of surgical research fellows, an expert panel with extensive clinical experience in the management of appendicitis discussed statements and recommendations. Statements and recommendations with more than 70 % agreement by the experts were selected for a web survey and the consensus meeting of the EAES in Bucharest in June 2015. EAES members and attendees at the EAES meeting in Bucharest could vote on these statements and recommendations. In the case of more than 70 % agreement, the statement or recommendation was defined as supported by the scientific community. Results from both the web survey and the consensus meeting in Bucharest are presented as percentages. In total, 46 statements and recommendations were selected for the web survey and consensus meeting. More than 232 members and attendees voted on them. In 41 of 46 statements and recommendations, more than 70 % agreement was reached. All 46 statements and recommendations are presented in this paper. They comprise topics regarding the diagnostic work-up, treatment indications, procedural aspects and post-operative care. The consensus meeting produced 46 statements and recommendations on the diagnostic work-up and management of appendicitis. The majority of the EAES members supported these statements. These consensus proceedings provide additional guidance to surgeons and surgical residents providing care to patients with appendicitis. Electronic supplementary materialThe online version of this article (doi:10.1007/s00464-016-5245-7) contains supplementary material, which is available to authorized users.

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Comparing the effectiveness of ropivacaine 0.5% versus ropivacaine 0.2% for transabdominis plane block in providing postoperative analgesia after appendectomy

Abstract: The effectiveness of two different concentrations of ropivacaine (0.5% versus 0.2%) given via TAP block was comparable in providing postoperative analgesia for patients undergoing appendectomy.

Cited by 21 publications

References 21 publications

Effect of Scalp Nerve Block with Ropivacaine on Postoperative Pain in Patients Undergoing Craniotomy: A Randomized, Double Blinded Study

Effect of Scalp Nerve Block with Ropivacaine on Postoperative Pain in Patients Undergoing Craniotomy: A Randomized, Double Blinded Study

Comparative evaluation of ropivacaine and levobupivacaine for postoperative analgesia after ultrasound-guided paravertebral block in patients undergoing percutaneous nephrolithotomy

Diagnosis and management of acute appendicitis. EAES consensus development conference 2015

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