Peritoneal Nebulization of Ropivacaine during Laparoscopic Cholecystectomy: Dose Finding and Pharmacokinetic Study
Background. Intraperitoneal nebulization of ropivacaine reduces postoperative pain and morphine consumption after laparoscopic surgery. The aim of this multicenter double-blind randomized controlled trial was to assess the efficacy of different doses and dose-related absorption of ropivacaine when n...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Pain Research and Management |
| Online Access: | http://dx.doi.org/10.1155/2017/4260702 |
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| author | Massimo Allegri Martina Ornaghi Catherine E. Ferland Dario Bugada Yash Meghani Serena Calcinati Manuela De Gregori Federica Lovisari Krishnaprabha Radhakrishnan Maria Cusato Stefano Scalia Catenacci Marta Somaini Guido Fanelli Pablo Ingelmo |
| author_facet | Massimo Allegri Martina Ornaghi Catherine E. Ferland Dario Bugada Yash Meghani Serena Calcinati Manuela De Gregori Federica Lovisari Krishnaprabha Radhakrishnan Maria Cusato Stefano Scalia Catenacci Marta Somaini Guido Fanelli Pablo Ingelmo |
| author_sort | Massimo Allegri |
| collection | DOAJ |
| description | Background. Intraperitoneal nebulization of ropivacaine reduces postoperative pain and morphine consumption after laparoscopic surgery. The aim of this multicenter double-blind randomized controlled trial was to assess the efficacy of different doses and dose-related absorption of ropivacaine when nebulized in the peritoneal cavity during laparoscopic cholecystectomy. Methods. Patients were randomized to receive 50, 100, or 150 mg of ropivacaine 1% by peritoneal nebulization through a nebulizer. Morphine consumption, pain intensity in the abdomen, wound and shoulder, time to unassisted ambulation, discharge time, and adverse effects were collected during the first 48 hours after surgery. The pharmacokinetics of ropivacaine was evaluated using high performance liquid chromatography. Results. Nebulization of 50 mg of ropivacaine had the same effect of 100 or 150 mg in terms of postoperative morphine consumption, shoulder pain, postoperative nausea and vomiting, activity resumption, and hospital discharge timing (>0.05). Plasma concentrations did not reach toxic levels in any patient, and no significant differences were observed between groups (P>0.05). Conclusions. There is no enhancement in analgesic efficacy with higher doses of nebulized ropivacaine during laparoscopic cholecystectomy. When administered with a microvibration-based aerosol humidification system, the pharmacokinetics of ropivacaine is constant and maintains an adequate safety profile for each dosage tested. |
| format | Article |
| id | doaj-art-5efaee340bdf4cd9b23c798a97357789 |
| institution | Kabale University |
| issn | 1203-6765 1918-1523 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pain Research and Management |
| spelling | doaj-art-5efaee340bdf4cd9b23c798a973577892025-02-03T05:58:17ZengWileyPain Research and Management1203-67651918-15232017-01-01201710.1155/2017/42607024260702Peritoneal Nebulization of Ropivacaine during Laparoscopic Cholecystectomy: Dose Finding and Pharmacokinetic StudyMassimo Allegri0Martina Ornaghi1Catherine E. Ferland2Dario Bugada3Yash Meghani4Serena Calcinati5Manuela De Gregori6Federica Lovisari7Krishnaprabha Radhakrishnan8Maria Cusato9Stefano Scalia Catenacci10Marta Somaini11Guido Fanelli12Pablo Ingelmo13Department of Anaesthesia, ICU and Pain Therapy, University Hospital of Parma, Parma, ItalyDepartment of Anaesthesia and Intensive Care, San Gerardo Hospital of Monza, Milan Bicocca University, Milan, ItalySIMPAR Group (Study in Multidisciplinary Pain Research), Parma, ItalyDepartment of Anaesthesia, ICU and Pain Therapy, University Hospital of Parma, Parma, ItalyDepartment of Anaesthesia, Montreal Children’s Hospital, McGill University, Montréal, QC, CanadaDepartment of Anaesthesia and Intensive Care, San Gerardo Hospital of Monza, Milan Bicocca University, Milan, ItalySIMPAR Group (Study in Multidisciplinary Pain Research), Parma, ItalyDepartment of Anaesthesia and Intensive Care, San Gerardo Hospital of Monza, Milan Bicocca University, Milan, ItalyDepartment of Anaesthesia, Montreal Children’s Hospital, McGill University, Montréal, QC, CanadaLaboratory of Clinical Pharmacokinetics, IRCCS Fondazione Policlinico San Matteo, Pavia, ItalyDepartment of Anaesthesia and Intensive Care, San Gerardo Hospital of Monza, Milan Bicocca University, Milan, ItalyDepartment of Anaesthesia and Intensive Care I, ASST Grande Ospedale Metropolitano Niguarda, University of Milano-Bicocca, Milan, ItalyDepartment of Anaesthesia, ICU and Pain Therapy, University Hospital of Parma, Parma, ItalySIMPAR Group (Study in Multidisciplinary Pain Research), Parma, ItalyBackground. Intraperitoneal nebulization of ropivacaine reduces postoperative pain and morphine consumption after laparoscopic surgery. The aim of this multicenter double-blind randomized controlled trial was to assess the efficacy of different doses and dose-related absorption of ropivacaine when nebulized in the peritoneal cavity during laparoscopic cholecystectomy. Methods. Patients were randomized to receive 50, 100, or 150 mg of ropivacaine 1% by peritoneal nebulization through a nebulizer. Morphine consumption, pain intensity in the abdomen, wound and shoulder, time to unassisted ambulation, discharge time, and adverse effects were collected during the first 48 hours after surgery. The pharmacokinetics of ropivacaine was evaluated using high performance liquid chromatography. Results. Nebulization of 50 mg of ropivacaine had the same effect of 100 or 150 mg in terms of postoperative morphine consumption, shoulder pain, postoperative nausea and vomiting, activity resumption, and hospital discharge timing (>0.05). Plasma concentrations did not reach toxic levels in any patient, and no significant differences were observed between groups (P>0.05). Conclusions. There is no enhancement in analgesic efficacy with higher doses of nebulized ropivacaine during laparoscopic cholecystectomy. When administered with a microvibration-based aerosol humidification system, the pharmacokinetics of ropivacaine is constant and maintains an adequate safety profile for each dosage tested.http://dx.doi.org/10.1155/2017/4260702 |
| spellingShingle | Massimo Allegri Martina Ornaghi Catherine E. Ferland Dario Bugada Yash Meghani Serena Calcinati Manuela De Gregori Federica Lovisari Krishnaprabha Radhakrishnan Maria Cusato Stefano Scalia Catenacci Marta Somaini Guido Fanelli Pablo Ingelmo Peritoneal Nebulization of Ropivacaine during Laparoscopic Cholecystectomy: Dose Finding and Pharmacokinetic Study Pain Research and Management |
| title | Peritoneal Nebulization of Ropivacaine during Laparoscopic Cholecystectomy: Dose Finding and Pharmacokinetic Study |
| title_full | Peritoneal Nebulization of Ropivacaine during Laparoscopic Cholecystectomy: Dose Finding and Pharmacokinetic Study |
| title_fullStr | Peritoneal Nebulization of Ropivacaine during Laparoscopic Cholecystectomy: Dose Finding and Pharmacokinetic Study |
| title_full_unstemmed | Peritoneal Nebulization of Ropivacaine during Laparoscopic Cholecystectomy: Dose Finding and Pharmacokinetic Study |
| title_short | Peritoneal Nebulization of Ropivacaine during Laparoscopic Cholecystectomy: Dose Finding and Pharmacokinetic Study |
| title_sort | peritoneal nebulization of ropivacaine during laparoscopic cholecystectomy dose finding and pharmacokinetic study |
| url | http://dx.doi.org/10.1155/2017/4260702 |
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