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Efficacy of ropivacaine by the concentration of 0.25%, 0.5%, and 0.75% on surgical performance, postoperative analgesia, and patient's satisfaction in inguinal hernioplasty: a randomized controlled trial.

Su Y, Zhang Z, Zhang Y, Li H, Shi W - Patient Prefer Adherence (2015)

Bottom Line: Accordingly, the interquartile range of satisfactory scores in both group C (0.75% ropivacaine) and group B (0.5% ropivacaine) were significantly higher (P<0.05) than in group A (0.25% ropivacaine).More cases in high-dose groups reported abnormal skin sensation; however, it did not negatively affect the satisfaction level of patients.The use of ultrasound-guided regional anesthesia with ropivacaine as an anesthetic in inguinal hernia repair for elderly patients is safe and effective, and ropivacaine is optimally effective at the concentration of 0.5% with least side effects.

View Article: PubMed Central - PubMed

Affiliation: Anesthesia Department, The Shenzhen People's Hospital, The Secondary Clinical Medical College of Jinan University, Shenzhen, Guangdong, People's Republic of China.

ABSTRACT

Background: The purpose of this study was to evaluate the use of different concentrations of ropivacaine in ultrasound-guided regional anesthesia with regard to postoperative analgesic and patient's satisfaction in elderly patients undergoing inguinal hernioplasty in the People's Republic of China.

Methods: A total of 60 patients (>75 years of age) who scheduled inguinal hernioplasty at the Shenzhen People's Hospital from December 2013 to March 2015 were randomly assigned to three groups: 0.25% ropivacaine (n=20), 0.5% ropivacaine (n=20), and 0.75% ropivacaine (n=20). Ultrasound-guided regional anesthesia was performed before every surgery. Non-invasive blood pressure and heart rate were recorded before the operation, during the first 5 minutes of the surgical procedure, and 5 minutes after the operation of the patients, and compared between the groups. Incidence of adverse reactions, postoperative Visual Analog Scale score, and analgesic effect were also recorded and analyzed.

Results: The surgical procedure and anesthesia was performed successfully in all patients. Patients with high-dose ropivacaine (0.5% and 0.75%) in ultrasound-guided regional anesthesia exhibited lower arterial pressure and lower heart rate during the operation when compared to low-dose group. The interquartile range of Visual Analog Scale scores in both group C (0.75% ropivacaine) and group B (0.5% ropivacaine) were significantly lower (P<0.05) than in group A (0.25% ropivacaine). Accordingly, the interquartile range of satisfactory scores in both group C (0.75% ropivacaine) and group B (0.5% ropivacaine) were significantly higher (P<0.05) than in group A (0.25% ropivacaine). More cases in high-dose groups reported abnormal skin sensation; however, it did not negatively affect the satisfaction level of patients.

Conclusion: The use of ultrasound-guided regional anesthesia with ropivacaine as an anesthetic in inguinal hernia repair for elderly patients is safe and effective, and ropivacaine is optimally effective at the concentration of 0.5% with least side effects.

No MeSH data available.


Related in: MedlinePlus

Satisfactory and VAS score in study subjects.Notes: (A) VAS scores of participants 12 hours after the operations in study subjects. (B) Satisfactory scores of participants 12 hours after the operations in study subjects. (C) Satisfactory scores of participants with or without abnormal skin sensation. N denotes patients with no abnormal skin sensation, Y denotes patients with abnormal skin sensation. (D) Reversed correlation of satisfactory score and VAS score. The scores from 60 patients were plotted where satisfactory score were analyzed as dependent variable and VAS score were considered as independent variable, P=0.001. Each diamond shaped plot stands for patient(s) that gave such score. Satisfactory levels are measured as 5=most satisfied and 0=not satisfied.Abbreviation: VAS, Visual Analog Scale.
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f1-ppa-9-1375: Satisfactory and VAS score in study subjects.Notes: (A) VAS scores of participants 12 hours after the operations in study subjects. (B) Satisfactory scores of participants 12 hours after the operations in study subjects. (C) Satisfactory scores of participants with or without abnormal skin sensation. N denotes patients with no abnormal skin sensation, Y denotes patients with abnormal skin sensation. (D) Reversed correlation of satisfactory score and VAS score. The scores from 60 patients were plotted where satisfactory score were analyzed as dependent variable and VAS score were considered as independent variable, P=0.001. Each diamond shaped plot stands for patient(s) that gave such score. Satisfactory levels are measured as 5=most satisfied and 0=not satisfied.Abbreviation: VAS, Visual Analog Scale.

Mentions: As shown in Figure 1A, the interquartile range of VAS score in both group C (0.75% ropivacaine) and group B (0.5% ropivacaine) were significantly lower (P<0.05) than in group A (0.25% ropivacaine). Accordingly, the interquartile range of satisfactory scores (Figure 1B) in both group C (0.75% ropivacaine) and group B (0.5% ropivacaine) were significantly higher (P<0.05) than in group A (0.25% ropivacaine), indicating that the patients were more satisfied with the surgery process when there was less pain after the surgery. No abnormal skin sensation reported in patients from group A (self-report), while one case in group B (n=20) and six cases in group C (n=20) reported abnormal skin sensation including tickling, burning, or tingling. The skin sensation reports were collected at the same time as the VAS and satisfactory scores were collected (12 hours after the operations). The abnormal skin sensation did not negatively affect the satisfaction level of patients (Figure 1C) while we observed a reverse correlation of satisfaction level to VAS scores (Figure 1D).


Efficacy of ropivacaine by the concentration of 0.25%, 0.5%, and 0.75% on surgical performance, postoperative analgesia, and patient's satisfaction in inguinal hernioplasty: a randomized controlled trial.

Su Y, Zhang Z, Zhang Y, Li H, Shi W - Patient Prefer Adherence (2015)

Satisfactory and VAS score in study subjects.Notes: (A) VAS scores of participants 12 hours after the operations in study subjects. (B) Satisfactory scores of participants 12 hours after the operations in study subjects. (C) Satisfactory scores of participants with or without abnormal skin sensation. N denotes patients with no abnormal skin sensation, Y denotes patients with abnormal skin sensation. (D) Reversed correlation of satisfactory score and VAS score. The scores from 60 patients were plotted where satisfactory score were analyzed as dependent variable and VAS score were considered as independent variable, P=0.001. Each diamond shaped plot stands for patient(s) that gave such score. Satisfactory levels are measured as 5=most satisfied and 0=not satisfied.Abbreviation: VAS, Visual Analog Scale.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4590637&req=5

f1-ppa-9-1375: Satisfactory and VAS score in study subjects.Notes: (A) VAS scores of participants 12 hours after the operations in study subjects. (B) Satisfactory scores of participants 12 hours after the operations in study subjects. (C) Satisfactory scores of participants with or without abnormal skin sensation. N denotes patients with no abnormal skin sensation, Y denotes patients with abnormal skin sensation. (D) Reversed correlation of satisfactory score and VAS score. The scores from 60 patients were plotted where satisfactory score were analyzed as dependent variable and VAS score were considered as independent variable, P=0.001. Each diamond shaped plot stands for patient(s) that gave such score. Satisfactory levels are measured as 5=most satisfied and 0=not satisfied.Abbreviation: VAS, Visual Analog Scale.
Mentions: As shown in Figure 1A, the interquartile range of VAS score in both group C (0.75% ropivacaine) and group B (0.5% ropivacaine) were significantly lower (P<0.05) than in group A (0.25% ropivacaine). Accordingly, the interquartile range of satisfactory scores (Figure 1B) in both group C (0.75% ropivacaine) and group B (0.5% ropivacaine) were significantly higher (P<0.05) than in group A (0.25% ropivacaine), indicating that the patients were more satisfied with the surgery process when there was less pain after the surgery. No abnormal skin sensation reported in patients from group A (self-report), while one case in group B (n=20) and six cases in group C (n=20) reported abnormal skin sensation including tickling, burning, or tingling. The skin sensation reports were collected at the same time as the VAS and satisfactory scores were collected (12 hours after the operations). The abnormal skin sensation did not negatively affect the satisfaction level of patients (Figure 1C) while we observed a reverse correlation of satisfaction level to VAS scores (Figure 1D).

Bottom Line: Accordingly, the interquartile range of satisfactory scores in both group C (0.75% ropivacaine) and group B (0.5% ropivacaine) were significantly higher (P<0.05) than in group A (0.25% ropivacaine).More cases in high-dose groups reported abnormal skin sensation; however, it did not negatively affect the satisfaction level of patients.The use of ultrasound-guided regional anesthesia with ropivacaine as an anesthetic in inguinal hernia repair for elderly patients is safe and effective, and ropivacaine is optimally effective at the concentration of 0.5% with least side effects.

View Article: PubMed Central - PubMed

Affiliation: Anesthesia Department, The Shenzhen People's Hospital, The Secondary Clinical Medical College of Jinan University, Shenzhen, Guangdong, People's Republic of China.

ABSTRACT

Background: The purpose of this study was to evaluate the use of different concentrations of ropivacaine in ultrasound-guided regional anesthesia with regard to postoperative analgesic and patient's satisfaction in elderly patients undergoing inguinal hernioplasty in the People's Republic of China.

Methods: A total of 60 patients (>75 years of age) who scheduled inguinal hernioplasty at the Shenzhen People's Hospital from December 2013 to March 2015 were randomly assigned to three groups: 0.25% ropivacaine (n=20), 0.5% ropivacaine (n=20), and 0.75% ropivacaine (n=20). Ultrasound-guided regional anesthesia was performed before every surgery. Non-invasive blood pressure and heart rate were recorded before the operation, during the first 5 minutes of the surgical procedure, and 5 minutes after the operation of the patients, and compared between the groups. Incidence of adverse reactions, postoperative Visual Analog Scale score, and analgesic effect were also recorded and analyzed.

Results: The surgical procedure and anesthesia was performed successfully in all patients. Patients with high-dose ropivacaine (0.5% and 0.75%) in ultrasound-guided regional anesthesia exhibited lower arterial pressure and lower heart rate during the operation when compared to low-dose group. The interquartile range of Visual Analog Scale scores in both group C (0.75% ropivacaine) and group B (0.5% ropivacaine) were significantly lower (P<0.05) than in group A (0.25% ropivacaine). Accordingly, the interquartile range of satisfactory scores in both group C (0.75% ropivacaine) and group B (0.5% ropivacaine) were significantly higher (P<0.05) than in group A (0.25% ropivacaine). More cases in high-dose groups reported abnormal skin sensation; however, it did not negatively affect the satisfaction level of patients.

Conclusion: The use of ultrasound-guided regional anesthesia with ropivacaine as an anesthetic in inguinal hernia repair for elderly patients is safe and effective, and ropivacaine is optimally effective at the concentration of 0.5% with least side effects.

No MeSH data available.


Related in: MedlinePlus