Print version ISSN 1806-0013
CARVALHO, André Laranjeira de et al. Preemptive activity of incision infiltration with 0.75% ropivacaine in patients submitted to inguinal hernia repair. Rev. dor [online]. 2011, vol.12, n.4, pp. 321-326. ISSN 1806-0013. http://dx.doi.org/10.1590/S1806-00132011000400007.
BACKGROUND AND OBJECTIVES: The effectiveness of preemptive analgesia as compared to the conventional regimen for postoperative pain control is still controversial. This study aimed at evaluating the effectiveness of local infiltration with 0.75% ropivacaine before and after the incision of inguinal hernia repair surgeries in postoperative pain intensity, analgesics consumption and time elapsed for first analgesic dose request. METHOD: After the Institutional Research Ethics Committee approval, 60 patients, physical status P1 or P2, aged between 15 and 65 years, submitted to inguinal hernia repair under general anesthesia with isoflurane and fentanyl were randomly distributed in three groups: A - skin, subcutaneous and muscle infiltration before incision with 2 mg/kg of 0.75% ropivacaine; D - skin, subcutaneous and muscle infiltration after incision with 2 mg/kg of 0.75% ropivacaine; and C - control group, without infiltration. All patients received dipirone (2 g), 30 minutes before the end of anesthesia. A patient-controlled analgesia pump with morphine was used after anesthetic recovery. Pain intensity with visual analog scale, total morphine consumption and time for the first morphine dose request were evaluated during 24 hours. RESULTS: Morphine consumption was significantly lower in the A group (1.5 mg) as compared to the D group (5.5 mg) or to the control group (17 mg). Time for first morphine dose request was significantly longer for the A group and pain intensity was lower in all moments as compared to C group and in the last 18 h as compared to the group. CONCLUSION: Preoperative incision infiltration with ropivacaine significantly decreases postoperative pain intensity and morphine consumption and delays the time for first morphine dose request.
Keywords : Analgesia; Inguinal hernia; Local anesthetics; Surgery.