Ropivacaine wound infiltration: a fast-track approach in patients undergoing thoracotomy surgery.

BACKGROUND: Postoperative pain impairs enhanced recovery in patients after various surgeries. Local use of ropivacaine has become an effective strategy for postoperative pain management. The aim of this study was to assess the effectiveness and safety of wound infiltration with ropivacaine for postoperative analgesia as a fast-track approach in patients undergoing thoracotomy surgery.

MATERIALS AND METHODS: Forty adult patients with esophageal cancer scheduled for selective thoracotomy surgery were enrolled in this double-blind, randomized, controlled study. Patients were randomized (1:1) to receive ropivacaine or placebo wound infiltration before incision closure. Numerical rating score (NRS), postoperative analgesics consumption, length of hospital stay, time to anal exsufflation, defecation, ambulation, and patient satisfaction scores were recorded. Side effects including allergic reaction, nausea, vomiting, wound infection, and pneumonia were also assessed.

RESULTS: NRS was significantly decreased in the ropivacaine group with less consumption of postsurgery analgesics. The ropivacaine group also showed shorter postoperative hospital stays, earlier anal exsufflation and ambulation, and higher patient satisfaction scores. However, there were no significant differences between the two groups regarding time of defecation. No allergic reactions occurred in either group. The incidences of nausea, vomiting, wound infection, and pneumonia were similar.

CONCLUSIONS: The present study showed that ropivacaine wound infiltration could be a safe and effective fast-track approach for patients undergoing thoracotomy surgery.