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Does intraperitoneal ropivacaine reduce postoperative inflammation? A prospective, double-blind, placebo-controlled
Jane Hayden1, Anil Gupta2, Sven-Egron Thörn1
1Department of Anesthesiology and Intensive Care, Institute of Clinical sciences, Sahlgrenska Academy, University of Gothenburg, Västra Götalandsregionen, Sahlgrenska University Hospital, Gothenburg, Sweden.
Acta Anaesthesiologica Scandinavica
|June 18, 2019
Summary
Perioperative intraperitoneal ropivacaine did not significantly reduce systemic inflammation after ovarian cancer surgery. However, it did lower serum cortisol levels, indicating a potential stress response modulation.
Area of Science:
- Anesthesiology
- Surgical Oncology
- Immunology
Background:
- Postoperative inflammation is a common surgical stress response.
- Local anesthetics (LA) possess anti-inflammatory properties.
- Investigating LA's role in mitigating surgical inflammation is crucial.
Purpose of the Study:
- To evaluate if intraperitoneal local anesthetics (LA) administered perioperatively inhibit inflammatory cytokine expression.
- To assess the impact of intraperitoneal ropivacaine on the systemic inflammatory and stress response following ovarian cancer surgery.
Main Methods:
- A randomized, double-blind, placebo-controlled study (NCT02256228) involving patients undergoing ovarian cancer surgery.
- Patients received either intraperitoneal ropivacaine or saline perioperatively via an inserted catheter.
- Systemic cytokines, plasma ropivacaine, serum glucose, cortisol, and insulin were measured at various time points.
Main Results:
- No significant difference in systemic cytokine expression was observed between the ropivacaine and placebo groups.
- Serum cortisol levels were significantly lower in the ropivacaine group at 6 hours post-surgery (P=0.023).
- Serum glucose and insulin levels were similar between groups, and ropivacaine concentrations remained below toxic levels.
Conclusions:
- Perioperative intraperitoneal ropivacaine did not reduce the systemic inflammatory response in this study.
- A significant reduction in serum cortisol suggests a potential modulation of the stress response.
- Further research is needed to explore the therapeutic potential of local anesthetics in managing surgical stress and inflammation.
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