Surgical Pain Control With Ropivacaine by Atomized Delivery (Spray): A Randomized Controlled Trial

Area of Science:

• Anesthesiology
• Gynecologic Surgery
• Pain Management

Background:

• Minimally invasive pelvic surgery often involves significant postoperative pain.
• Intraoperative analgesia strategies are crucial for patient recovery.
• Atomized intraperitoneal ropivacaine (AIR) has shown promise in other surgical fields.

Purpose of the Study:

• To evaluate the efficacy of AIR as an adjunct to anesthesia in minimally invasive pelvic surgery.
• To assess the impact of AIR on postoperative pain and narcotic use.
• To compare AIR with atomized intraperitoneal saline (AIS) in gynecologic procedures.

Main Methods:

• A double-blind, randomized controlled trial was conducted.
• Fifty-five patients undergoing laparoscopic or robotic gynecologic procedures were included.
• Patients received either AIR or AIS (2 mg/kg) post-pneumoperitoneum.

Main Results:

• Postoperative Visual Analog Scale (VAS) pain scores at 2, 4, 8, and 12 hours were not significantly different between AIR and AIS groups.
• Total postoperative narcotic use was similar between the two groups.
• Demographic and surgical variables were comparable, except for operative duration.

Conclusions:

• Intraperitoneal ropivacaine did not provide a statistically significant reduction in postoperative VAS scores.
• AIR may not offer benefits in minimally invasive gynecologic procedures, unlike in general surgery.
• Further investigation is warranted to explore the role of AIR in gynecologic surgery.