Article
Ropivacain: preemptive analgesia in vitreoretinal surgery
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Published: | September 22, 2004 |
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Outline
Text
Objective
Vitrectomies are performed either in general anesthesia or in local anesthesia. Postoperative pain is expected to be less in patients with local anesthesia because of prolonged action of the local anesthetic. Preemptive analgesia is based on the idea that analgesia initiated before a nociceptive event will be more effective than analgesia commenced afterwards. We investigated the efficacy of additional pre- or postoperative local anesthetic to general anesthesia.
Methods
60 patients scheduled for pars plana vitrectomy without buckling were enrolled in the study. All patients underwent general anesthesia, 45 with preoperative (group A-C) and 15 with postoperative local anesthesia (group D). Additional local anesthetic was Ropivacain 1%: Group A: 1 ml; group B 3 ml und group C and D 5 ml. Subjective postoperative pain was determined using the visual analogue scale.
Results
The additional preoperative application of local anesthesia resulted in less pain in group C than additional postoperative application in group D (p < 0.013). There were no differences among group A, B and D.
Conclusions
It is suggested that local anesthesia with at least 5 ml Ropivacain 1% preoperatively in addition to general anesthesia provides the best comfort for the patient in the postoperative period after vitreoretinal surgery.