Wound infiltration with ropivacaine offers no analgesic benefit after thyroid surgery.

pearl

• Mihaela Miu, Catherine Royer, Carmen Gaillat, Barbara Schaup, Fabrice Menegaux, Olivier Langeron, Bruno Riou, and Frédéric Aubrun.
• From the Departments of *Anesthesia and Critical Care, †General Surgery, and ‡Emergency Medicine, Pitié-Salpetrière Hospital, Pierre et Marie Curie University, Paris, France; and §Department of Anesthesia and Critical Care, Croix-Rousse Hospital, Claude Bernard Lyon 1 University, Lyon, France.
• Anesth. Analg. 2016 Feb 1; 122 (2): 559-64.

BackgroundSurgical site infiltration with local anesthetic reduces analgesic requests in various types of surgeries. Because thyroid surgery may induce severe postoperative pain, we tested the hypothesis that ropivacaine surgical site infiltration would significantly decrease postoperative administration of morphine in patients undergoing thyroid surgery.MethodsWe performed a double-blind, placebo-controlled superiority trial to assess the efficacy of surgical site analgesia with ropivacaine (10 mL, 75 mg) performed at the end of thyroid surgery in adult patients. The primary end point was the proportion of patients not requiring IV morphine in the postanesthesia care unit.ResultsOne hundred sixty-three patients completed the study, 85 in the placebo group and 88 in the ropivacaine group. The proportion of patients requiring morphine administration in the postanesthesia care unit (55% vs 53%, P = 0.80), the dose of IV morphine administered (5.6 ± 6.1 vs 5.5 ± 6.0 mg, P = 0.90), the total dose of opioids administered (expressed as oral morphine equivalent dose: 64 ± 27 vs 69 ± 29 mg, P = 0.20), and the visual analog pain scale over the first 24 hours were not significantly different between groups. The incidence of adverse events (36% vs 39%, P = 0.88), morphine-related adverse events (19% vs 17%, P = 0.84), serious adverse events (0% vs 2%, P = 0.50), and the patient satisfaction scores (9 ± 1 vs 9 ± 1, P = 0.70) was not significantly different between the 2 groups.ConclusionsSurgical site analgesia with ropivacaine at the end of thyroid surgery is not associated with any significant analgesic benefit.

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