Key result
Wound site infiltration with ropivacaine provided a longer duration of analgesia and better analgesic effect compared to bupivacaine for postoperative pain relief.
Why the study?
Postoperative pain has adverse physiological and psychological effects, encouraging multimodal analgesia including local wound infiltration to reduce sensitization and hyperalgesia.
Does ropivacaine improve postoperative analgesia compared to bupivacaine in patients undergoing routine surgeries under general anaesthesia?
RCT (n=60)
Single-blind
Randomized
No
Does ropivacaine improve postoperative analgesia compared to bupivacaine in patients undergoing routine surgeries under general anaesthesia?
Ropivacaine provides superior and longer-lasting postoperative analgesia with better hemodynamic stability compared to bupivacaine for wound infiltration.
Favors ropivacaine for wound infiltration analgesia; extends RCT evidence guiding local anesthetic selection postoperatively.
BACKGROUND Post-operative pain is a ubiquitous finding following any surgeries. It has physiological and psychological effect in patients. The source and degree of nociceptive stimulation differ among individuals and type of surgeries. In this regard, multimodal analgesic approach has been encouraged for post-operative pain relief, local infiltration of wound site being simplest among them. This procedure reduces the sensitisation and consequent hyperalgesia by cutting down afferent impulses from site of incision and injury. METHODS This is a single blind randomized clinical trial conducted at surgery main operation theatre, surgery indoor wards for a duration of 2 years. 60 patients posted for routine surgeries under general anaesthesia were taken as study subjects and were randomly divided into 2 groups of 30 each. Before skin closure, skin wound site was infiltrated at 1ml/cm according to the following schedule - Group B: received Inj. Bupivacaine plain (0.2 %), Group R: received Inj. Ropivacaine plain (0.2 %). All the patients were followed up for 24 hours and post-operative pain score parameters (Visual Analogue Score) were taken at 1 hour, 2-hour, 6-hour, 10 hour and 24 hours. The time duration till the requirement of first dose of rescue analgesia was noted down. Data was analysed using chi-square test, student t - test and statistical significance was set at P < 0.05. RESULTS Hemodynamic stability was more with Ropivacaine as the fall in blood pressure and heart rate was not drastic. Duration of analgesia was longer with Ropivacaine. Analgesia was better with Ropivacaine. Both the drugs caused analgesia of significant extent. No cardiotoxicity or any other adverse reaction was observed with either drug in this study. CONCLUSIONS Ropivacaine is having longer duration of analgesia and better analgesic effect than bupivacaine. KEYWORDS Postoperative, Analgesic, Wound, Infiltration, Bupivacaine, Ropivacaine
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Patel et al. (2021) conducted an RCT in Post-operative pain (n=60). Ropivacaine vs. Bupivacaine (0.2% plain, infiltrated at 1ml/cm) was evaluated on Post-operative pain score (Visual Analogue Score) and time to first rescue analgesia. Wound site infiltration with ropivacaine provided a longer duration of analgesia and better analgesic effect compared to bupivacaine for postoperative pain relief.
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