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The benefits of preincision ropivacaine infiltration for reducing postoperative pain after robotic bilateral axillo-breast approach thyroidectomy: a prospective, randomized, double-blind, placebo-controlled study.

Kang KH, Kim BS, Kang H - Ann Surg Treat Res (2015)

Bottom Line: Fentanyl use for analgesia and BHC were also significantly lower in group L compared with group C during the first postoperative 6 and 2 hours, respectively (P < 0.05).The total consumption of fentanyl was significantly lower in group L than in group C (P = 0.009).No significant differences were noted for baseline, postoperative mean BP, or HR.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: The aim of this study was to evaluate the effects of preoperative ropivacaine infiltration in patients undergoing robotic thyroidectomy using the bilateral axillary breast approach method.

Methods: Using a randomized, double-blind study design, 34 consecutive female patients who underwent robotic thyroidectomy were randomly assigned to receive local infiltration to the skin flap site using either only 0.9% saline solution, 3 mL/kg (group C, n = 17) or 0.1% ropivacaine with saline, 3 mg/kg (group L, n = 17). Local anesthetic was administered prior to skin incision after the induction of general anesthesia. Postoperative pain was rated at 2, 6, 18, 30, 42, and 66 hours postoperatively by visual analogue scale (VAS) score. The bottom hit counts (BHC) from patient controlled analgesia and fentanyl consumption were evaluated. CRP levels, mean blood pressure (BP), and heart rate (HR) were also evaluated.

Results: VAS pain scores were significantly lower in group L than in group C from 2 to 42 hours (P < 0.05). Fentanyl use for analgesia and BHC were also significantly lower in group L compared with group C during the first postoperative 6 and 2 hours, respectively (P < 0.05). The total consumption of fentanyl was significantly lower in group L than in group C (P = 0.009). No significant differences were noted for baseline, postoperative mean BP, or HR.

Conclusion: Preoperative infiltration using ropivacaine with saline to all flap sites is a safe and effective method for reducing postoperative pain and postoperative fentanyl consumption in patients with robotic thyroidectomy.

No MeSH data available.


Related in: MedlinePlus

The wide robot flap dissection area. The infiltrated area before incision.
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Figure 1: The wide robot flap dissection area. The infiltrated area before incision.

Mentions: The fluid prepared for study treatments was infiltrated into the subcutaneous tissue of the skin flap site using 23-gause needle before skin incision. The infiltration lesion was bounded superiorly by thyroid cartilage, inferiorly by a line 2 cm below the clavicle, and laterally by the lateral border of the sternocleidomastoid muscle including trocar site (Fig. 1). After the preincisional infiltration was completed, a 12-mm circumareolar incision was made in the right breast for the camera port. For the remainder of the trocar access points, an 8-mm left circumareolar incision was made, as well as 8-mm incisions in both axillae. The robot was docked after a working space was created through the port incision. Robotic thyroid resection was then performed.


The benefits of preincision ropivacaine infiltration for reducing postoperative pain after robotic bilateral axillo-breast approach thyroidectomy: a prospective, randomized, double-blind, placebo-controlled study.

Kang KH, Kim BS, Kang H - Ann Surg Treat Res (2015)

The wide robot flap dissection area. The infiltrated area before incision.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4384283&req=5

Figure 1: The wide robot flap dissection area. The infiltrated area before incision.
Mentions: The fluid prepared for study treatments was infiltrated into the subcutaneous tissue of the skin flap site using 23-gause needle before skin incision. The infiltration lesion was bounded superiorly by thyroid cartilage, inferiorly by a line 2 cm below the clavicle, and laterally by the lateral border of the sternocleidomastoid muscle including trocar site (Fig. 1). After the preincisional infiltration was completed, a 12-mm circumareolar incision was made in the right breast for the camera port. For the remainder of the trocar access points, an 8-mm left circumareolar incision was made, as well as 8-mm incisions in both axillae. The robot was docked after a working space was created through the port incision. Robotic thyroid resection was then performed.

Bottom Line: Fentanyl use for analgesia and BHC were also significantly lower in group L compared with group C during the first postoperative 6 and 2 hours, respectively (P < 0.05).The total consumption of fentanyl was significantly lower in group L than in group C (P = 0.009).No significant differences were noted for baseline, postoperative mean BP, or HR.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: The aim of this study was to evaluate the effects of preoperative ropivacaine infiltration in patients undergoing robotic thyroidectomy using the bilateral axillary breast approach method.

Methods: Using a randomized, double-blind study design, 34 consecutive female patients who underwent robotic thyroidectomy were randomly assigned to receive local infiltration to the skin flap site using either only 0.9% saline solution, 3 mL/kg (group C, n = 17) or 0.1% ropivacaine with saline, 3 mg/kg (group L, n = 17). Local anesthetic was administered prior to skin incision after the induction of general anesthesia. Postoperative pain was rated at 2, 6, 18, 30, 42, and 66 hours postoperatively by visual analogue scale (VAS) score. The bottom hit counts (BHC) from patient controlled analgesia and fentanyl consumption were evaluated. CRP levels, mean blood pressure (BP), and heart rate (HR) were also evaluated.

Results: VAS pain scores were significantly lower in group L than in group C from 2 to 42 hours (P < 0.05). Fentanyl use for analgesia and BHC were also significantly lower in group L compared with group C during the first postoperative 6 and 2 hours, respectively (P < 0.05). The total consumption of fentanyl was significantly lower in group L than in group C (P = 0.009). No significant differences were noted for baseline, postoperative mean BP, or HR.

Conclusion: Preoperative infiltration using ropivacaine with saline to all flap sites is a safe and effective method for reducing postoperative pain and postoperative fentanyl consumption in patients with robotic thyroidectomy.

No MeSH data available.


Related in: MedlinePlus