Abstract
Purpose
To compare efficacy and patient outcome of wound infiltration with ropivacaine, lornoxicam, or their combination for control of pain following thyroid surgery.
Methods
Eighty patients underwent thyroid surgery were randomly assigned to one of four groups. Before skin closure, local tissues were infiltrated with 12 mL saline in Group S, with 10 mL of ropivacaine 0.75% plus 2 mL saline in Group R, with 2 mL of lornoxicam (8 mg) plus 10 mL saline in Group L, and with 10 mL ropivacaine 0.75% plus 2 mL lornoxicam (8 mg) in Group RL. Pain scores, total and incremental meperidine consumption were recorded at 30 min, one, two, three, four, six, eight, 12, 18, and 24 hr postoperatively. Time to first analgesic requirement, patient satisfaction, and duration of hospital stay were also compared after surgery.
Results
The pain scores in Group RL were significantly lower in the first 12 hr than in Group S, and in the first four hours than in Groups R and L (P < 0.01). The time to first analgesic requirement was significantly longer (14.8 ± 8.4 hr vs 5.9 ± 5.2 hr;P < 0.01), the total pethidine consumption was significantly less than Group S (34.0 ± 33.0 mg vs 78.0 ± 29.8 mg; P<0.001), return of gastrointestinal function, ambulation time, length of hospital stay (P < 0.05) were significantly shorter, and patient satisfaction (P < 0.01) was significantly better in Group RL than in Group S (P < 0.05).
Conclusion
Wound infiltration with ropivacaine 0.75% plus lornoxicam 8 mg combination improved postoperative pain control and patient comfort, and decreased the need for opioids than the use of either drug alone.
Abstract
Objectif
Comparer ľefficacité ďune infiltration avec de la ropivacaïne, du lornoxicam ou leur combinaison après une opération de la thyroïde et comparer ľévolution des patients.
Méthode
Des patients devant être opérés à la thyroïde (80) ont été répartis en quatre groupes. Avant la fermeture cutanée, les tissus locaux ont été infiltrés avec 12 mL de solution saline dans le groupe S, 10 mL de ropivacaïne à 0,75 % plus 2 mL de solution saline dans le groupe R, 2 mL de lornoxicam (8 mg) plus 10 mL de solution saline dans le groupe L et 10 mL de ropivacaïne à 0,75 % plus 2 mL de lornoxicam (8 mg) dans le groupe RL. Les scores de douleur et la consommation totale et incrémentielle de mépéridine ont été notés à 30 min, puis à une, deux, trois, quatre, six huit, 12, 18 et 24 h après ľopération. Le moment de la première demande ďanalgésique, la satisfaction du patient et la longueur du séjour ont été comparés.
Résultats
Les scores de douleurs ont été significativement plus bas chez les patients du groupe RL que chez ceux du groupe S pendant les 12 premières heures et que chez ceux des groupes R et L pendant les quatre premières heures (P < 0,01). Le moment de la première demande ďanalgésique a été plus tardif (14,8 ± 8,4 h vs 5,9 ± 5,2 h ; P < 0,01), la consommation totale de péthidine a été plus basse que dans le groupe S (34,0 ± 33,0 mg vs 78,0 ± 29,8 mg ; P < 0,001), le retour de la fonction gastro-intestinale et de la marche a été plus précoce, la longueur du séjour hospitalier (P < 0,05) plus courte et la satisfaction des patients (P < 0,01) meilleure dans le groupe RL que dans le groupe S (P < 0,05).
Conclusion
Ľinfiltration dans le site ďincision avec une combinaison de ropivacaïne à 0,75 % et de 8 mg de lornoxicam a amélioré le contrôle postopératoire de la douleur et le confort des patients et a diminué les besoins ďopioïdes par rapport à ľusage ďun seul médicament.
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Karamanlioglu, B., Turan, A., Memis, D. et al. Infiltration with ropivacaine plus lornoxicam reduces postoperative pain and opioid consumption. Can J Anesth 52, 1047–1053 (2005). https://doi.org/10.1007/BF03021603
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DOI: https://doi.org/10.1007/BF03021603