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Ropivacaine instillation through subgaleal drain: A novel approach for acute post-craniotomy pain

BACKGROUND AND AIMS: Post-craniotomy pain has often been overlooked and undertreated. Various classes of analgesic drugs have been used, not without limitations. Therefore, we planned to study the novel technique of wound instillation of ropivacaine through the surgical drain in patients undergoing...

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Autores principales: Bala, Renu, Gehlaut, Preeti, Mittal, Kiran, Singh, Ishwar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9468998/
https://www.ncbi.nlm.nih.gov/pubmed/36111089
http://dx.doi.org/10.4103/ija.ija_646_21
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author Bala, Renu
Gehlaut, Preeti
Mittal, Kiran
Singh, Ishwar
author_facet Bala, Renu
Gehlaut, Preeti
Mittal, Kiran
Singh, Ishwar
author_sort Bala, Renu
collection PubMed
description BACKGROUND AND AIMS: Post-craniotomy pain has often been overlooked and undertreated. Various classes of analgesic drugs have been used, not without limitations. Therefore, we planned to study the novel technique of wound instillation of ropivacaine through the surgical drain in patients undergoing supratentorial craniotomy to study its effect on post-craniotomy pain, analgesic requirement in the post-operative period along with the recovery profile of the patient and the side effects. METHODS: This prospective, randomised, placebo-controlled, double-blinded study enroled 50 patients of either gender, scheduled to undergo elective craniotomy, under general anaesthesia. They were randomly divided into two groups and received either 12 ml of 0.25% ropivacaine (group R) or 12 ml of normal saline (group NS), through the subgaleal drain, after the closure of the dura. Pain scores were assessed at 1, 2, 4, 8 and 24 hours post-operatively. Student’s t-test was used for comparison of continuous variables and the Chi-square test or Fisher’s exact test was used for comparing the nominal categorical data. RESULTS: The visual analogue scale score was higher in group NS than in group R, and the difference was statistically significant (P = 0.012, 0.016, and 0.005 at 0, 1, and 2 post-operative hours, respectively). The difference in the mean emergence time in the two groups was 1.12 minutes (P = 0.024). CONCLUSION: Single-time wound instillation of ropivacaine (12 ml of 0.25%) through surgical (subgaleal) drain during wound closure is an effective and simple technique for reducing post-operative pain and analgesic consumption and early emergence in neurosurgical patients undergoing supratentorial craniotomy.
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spelling pubmed-94689982022-09-14 Ropivacaine instillation through subgaleal drain: A novel approach for acute post-craniotomy pain Bala, Renu Gehlaut, Preeti Mittal, Kiran Singh, Ishwar Indian J Anaesth Original Article BACKGROUND AND AIMS: Post-craniotomy pain has often been overlooked and undertreated. Various classes of analgesic drugs have been used, not without limitations. Therefore, we planned to study the novel technique of wound instillation of ropivacaine through the surgical drain in patients undergoing supratentorial craniotomy to study its effect on post-craniotomy pain, analgesic requirement in the post-operative period along with the recovery profile of the patient and the side effects. METHODS: This prospective, randomised, placebo-controlled, double-blinded study enroled 50 patients of either gender, scheduled to undergo elective craniotomy, under general anaesthesia. They were randomly divided into two groups and received either 12 ml of 0.25% ropivacaine (group R) or 12 ml of normal saline (group NS), through the subgaleal drain, after the closure of the dura. Pain scores were assessed at 1, 2, 4, 8 and 24 hours post-operatively. Student’s t-test was used for comparison of continuous variables and the Chi-square test or Fisher’s exact test was used for comparing the nominal categorical data. RESULTS: The visual analogue scale score was higher in group NS than in group R, and the difference was statistically significant (P = 0.012, 0.016, and 0.005 at 0, 1, and 2 post-operative hours, respectively). The difference in the mean emergence time in the two groups was 1.12 minutes (P = 0.024). CONCLUSION: Single-time wound instillation of ropivacaine (12 ml of 0.25%) through surgical (subgaleal) drain during wound closure is an effective and simple technique for reducing post-operative pain and analgesic consumption and early emergence in neurosurgical patients undergoing supratentorial craniotomy. Wolters Kluwer - Medknow 2022-07 2022-07-22 /pmc/articles/PMC9468998/ /pubmed/36111089 http://dx.doi.org/10.4103/ija.ija_646_21 Text en Copyright: © 2022 Indian Journal of Anaesthesia https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Bala, Renu
Gehlaut, Preeti
Mittal, Kiran
Singh, Ishwar
Ropivacaine instillation through subgaleal drain: A novel approach for acute post-craniotomy pain
title Ropivacaine instillation through subgaleal drain: A novel approach for acute post-craniotomy pain
title_full Ropivacaine instillation through subgaleal drain: A novel approach for acute post-craniotomy pain
title_fullStr Ropivacaine instillation through subgaleal drain: A novel approach for acute post-craniotomy pain
title_full_unstemmed Ropivacaine instillation through subgaleal drain: A novel approach for acute post-craniotomy pain
title_short Ropivacaine instillation through subgaleal drain: A novel approach for acute post-craniotomy pain
title_sort ropivacaine instillation through subgaleal drain: a novel approach for acute post-craniotomy pain
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9468998/
https://www.ncbi.nlm.nih.gov/pubmed/36111089
http://dx.doi.org/10.4103/ija.ija_646_21
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