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Intraperitoneal Ropivacaine Nebulization for Pain Control After Gynecologic Laparoscopic Surgery

Phase 3
Completed
Conditions
Ovarian Cysts
Interventions
Registration Number
NCT01142622
Lead Sponsor
San Gerardo Hospital
Brief Summary

The purpose of this study is to assess if intraperitoneal nebulization of Ropivacaine 150 mg may prevent the use of morphine during the first day after laparoscopic ovarian cyst surgery.

Detailed Description

In a recent study the investigators found that nebulization of Ropivacaine 30 mg before or after gynaecologic laparoscopic surgery significantly reduces postoperative pain and postoperative morphine consumption.

Ropivacaine was effectively administered with non-heating nebulizers (AeronebPro®).

However, almost all patients still use morphine after surgery.

The investigators hypothesize that intraperitoneal nebulization of Ropivacaine 150 mg may prevent the use of morphine after the laparoscopic ovarian cyst surgery.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
140
Inclusion Criteria
  • Females 18-65 years old
  • ASA Score I-III
  • Scheduled for ovarian cyst laparoscopic surgery
  • Free from pain in preoperative period
  • Not using analgesic drugs before surgery
  • Without cognitive impairment or mental retardation
  • Written informed consent
Exclusion Criteria
  • Emergency/urgency surgery
  • Postoperative admission in an intensive care unit
  • Cognitive impairment or mental retardation
  • Progressive degenerative diseases of the CNS
  • Seizures or chronic therapy with antiepileptic drugs
  • Severe hepatic or renal impairment
  • Pregnancy or lactation
  • Allergy to one of the specific drugs under study
  • Acute infection or inflammatory chronic disease
  • Alcohol or drug addiction

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Ropivacaine nebulizationRopivacaine nebulizationPreoperative nebulization of 150 mg of Ropivacaine in the peritoneal cavity
Ropivacaine instillationRopivacaine instillationPreoperative instillation of 150 mg of Ropivacaine in the peritoneal cavity before surgery
Primary Outcome Measures
NameTimeMethod
Morphine consumption (mg)Up to 24 hours

The total dose of morphine at every evaluation after awakening will be quantified using the PACU clinical chart and/or PCA infusers memory display.

Secondary Outcome Measures
NameTimeMethod
Postoperative PainUp to 24 hours

Postoperative pain will be assessed by numeric ranking scale (NRS 0 to 10 points) at rest (static NRS) and after deep inspiration or cough (dynamic NRS). Pain after surgery will be differentiated as abdominal, wall pain, port wound pain, back pain and shoulder pain. The proportion of patients with adequate pain control after surgery (dynamic NRS \< 3) will also be assessed.

Time of unassisted walkingUp to 24 hours

Unassisted walking time is defined as the time in hours between PACU discharge and when the patient is able to walk out of his room and back to bed without any assistance.

Hospital morbidityUp to 24 hours

All complications or adverse effects associated or possibly associated with the interventions under study, surgery or anesthesia, will be quantified using the anesthesia charts, surgical charts and surgical database.

Hospital stayUp to 24 hours

We define hospital stay as the time in hours elapsed between surgery and hospital discharge. We evaluate the hospital stay with the post-anesthetic discharge scoring system (Modified-PADSS).

Quality of life after surgeryFour weeks after surgery

Quality of life will be assessed using the SF-36 questionnaire

Trial Locations

Locations (1)

San Gerardo Hospital

🇮🇹

Monza, MB, Italy

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