• Rev Gastroenterol Mex · Jan 2012

    Randomized Controlled Trial

    [Effectiveness of intercostal nerve block with ropivacaine in analgesia of patients undergoing emergency open cholecystectomy under general anesthesia].

    • M A Vizcarra-Román, J A Bahena-Aponte, A Cruz-Jarquín, Ja C Vázquez-García, and L E Cárdenas-Lailson.
    • Servicio de Cirugía General, Hospital Regional "Lic. Adolfo López Mateos". Av. Universidad N° 1321. Col. Florida, Delegación Álvaro Obregón, C.P. 01030. México D.F., México. vizromedic@yahoo.com.mx
    • Rev Gastroenterol Mex. 2012 Jan 1;77(1):9-14.

    IntroductionPostoperative pain after open cholecystectomy is associated with reduced respiratory function, longer recovery period before deambulation and oral food intake, and prolonged hospital stay. Intercostal nerve block provides satisfactory analgesia and ropivacaine is the most widely used local anesthetic agent in intercostal nerve block due to its excellent effectiveness, lower cardiovascular toxicity, and longer half-life.AimsTo evaluate intercostal nerve block effectiveness with ropivacaine in patients undergoing emergency open cholecystectomy under general anesthesia compared with conventional management.Material And MethodsA controlled clinical trial was carried out on 50 patients undergoing open cholecystectomy, 25 patients without intercostal nerve block versus 25 patients with intercostal nerve block using ropivacaine at 0.5% combined with epinephrine. Intraoperative minimum alveolar concentration and inhalation anesthetic use were evaluated. Tramadol as rescue analgesic agent and pain were evaluated during immediate postoperative period by means of the Visual Analog Scale at 8, 16, and 24 hours.ResultsMean inhalation anesthetic use was lower in the intercostal nerve block group with 13% vs 37% in the group without intercostal nerve block (p= 0.01). Rescue tramadol requirement was lower in the intercostal nerve block group than in the group without intercostal nerve block at 8 hours (8% vs 67%), 16 hours (0% vs 83%), and 24 hours (12% vs 79%) (p<0.0001). Visual Analog Scale for Pain results were similar in both groups.ConclusionsIntercostal nerve block reduces intraoperative inhalation anesthetic use, immediate postoperative pain, and tramadol intake as rescue analgesic agent in patients undergoing open cholecystectomy.

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