Efficacy and safety of 0.75% ropivacaine instillation into subinguinal wound in patients after bilateral microsurgical varicocelectomy: a bi-center, randomized, double-blind, placebo-controlled trial

Abstract

ObjectiveTo evaluate the efficacy and safety of 0.75% ropivacaine instillation into inguinal wound in patients who have undergone bilateral microsurgical varicocelectomy.Patients and methodsEighty-five men who were screened for bilateral varicoceles from March 2015 to July 2016 were randomized for the treatment. All patients underwent inguinal varicocelectomy by general anesthesia. After ligation of the internal spermatic veins from the spermatic cord, additional delivery of testis through inguinal incision site was done to ligate external spermatic veins and gubernacular veins. Before repairing external oblique aponeurosis, 6 mL of 0.75% ropivacaine and 6 mL of normal saline were instilled under the fascia and around the funiculus (spermatic cord) by a randomized and double-blind method. Visual analog scale (VAS) pain score and Prince Henry Pain Score (PHPS) were used for evaluating operative sites at 1, 2, 4, and 8 hours and 7 days after surgery. Safety and tolerability were evaluated throughout the course of this study by assessing adverse events.ResultsA total of 55 men completed the study. Of these 55 men, 31 received instillation of ropivacaine on the left operative site, while 24 received instillation of ropivacaine on the right operative site. VAS pain scores and PHPS in the ropivacaine-instilled operative site were significantly lower compared to those obtained with placebo at 2, 4, and 8 hours after surgery. In general, instillation of ropivacaine was safe and well tolerated in patients.ConclusionRopivacaine instillation into inguinal surgical site wound significantly reduced postoperative pain after microsurgical varicocelectomy.

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“…Cu et al . [ 16 ] studied the efficacy and safety of 0.75% ropivacaine instillation into inguinal wound on 55 patients who had undergone bilateral microsurgical varicocelectomy by general anesthesia. They found that VAS pain scores and Prince Henry Pain Score in the ropivacaine-instilled operative site were significantly lower compared to those obtained with placebo at 2, 4, and 8 h after surgery ( P < 0.05).…”

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“…In our previous study, we evaluated the efficacy and safety of 0.75% ropivacaine instillation into inguinal wounds in patients who underwent bilateral microsurgical varicocelectomy [ 2 ]. Before repairing the external oblique aponeurosis, 6 mL of 0.75% ropivacaine or 6 mL of normal saline was instilled under the fascia and around the funiculus (spermatic cord) in a randomized and double-blind study design.…”

“…Before repairing the external oblique aponeurosis, 6 mL of 0.75% ropivacaine or 6 mL of normal saline was instilled under the fascia and around the funiculus (spermatic cord) in a randomized and double-blind study design. Visual analogue scale (VAS) pain scores and the Prince Henry Pain Score (PHPS) were used for evaluating the operative sites at 1, 2, 4, and 8 hours and 7 days after surgery [ 2 ]. The VAS pain scores and PHPS at the ropivacaineinstilled operative sites were significantly lower than those in the placebo group at 2, 4, and 8 hours after surgery [ 2 ].…”

“…Visual analogue scale (VAS) pain scores and the Prince Henry Pain Score (PHPS) were used for evaluating the operative sites at 1, 2, 4, and 8 hours and 7 days after surgery [ 2 ]. The VAS pain scores and PHPS at the ropivacaineinstilled operative sites were significantly lower than those in the placebo group at 2, 4, and 8 hours after surgery [ 2 ]. In general, the instillation of ropivacaine was safe and well tolerated in patients [ 2 ].…”

“…The VAS pain scores and PHPS at the ropivacaineinstilled operative sites were significantly lower than those in the placebo group at 2, 4, and 8 hours after surgery [ 2 ]. In general, the instillation of ropivacaine was safe and well tolerated in patients [ 2 ]. Bupivacaine is a long-acting amide-based topical anesthetic that is commonly used in clinical practice [ 3 ], while ropivacaine is a new amino amide with a structure similar to that of bupivacaine.…”