PREOPERATIVE LOCAL INFILTRATION WITH ROPIVACAINE FOR POSTOPERATIVE PAIN RELIEF AFTER CHOLECYSTECTOMY

In a randomized, double-blind, placebo-controlled trial, we evaluated the use of preoperative local anesthesia with regard to postoperative pain. Before surgery in 66 patients scheduled for cholecystectomy, the abdominal wall along the proposed line of incision was infiltrated wi th 70 mL of 0.25% ropivacaine, 70 mt of 0.125% ropivacaine, or 70 mt o f saline. Wound pain at rest, wound pain during mobilization, and pres sure exerted to reach maximum pain tolerance were assessed after 6, 26 , 50, and 74 h and after 7 days. Consumption of analgesics was recorde d. At the 6-h assessment, there was a statistically significant dose-r elated decrease in wound pain during mobilization (P = 0.001) and an i ncrease of pressure exerted to reach maximum pain tolerance (P < 0.001 ). The tests were two-tailed and performed at a significance level of P < 0.05. There were no significant differences between the groups at later pain control assessments. The median time to first request for p ostoperative analgesics was significantly shorter (P = 0.014) in the s aline group than in the ropivacaine 0.25% group. These effects are sug gested to be a residual anesthetic effect of ropivacaine. The study gi ves no support to the hypothesis that preoperative local anesthetics d ampen the inflammatory response and ensuing hyperalgesia.