Analgesic effect of parecoxib combined with ropivacaine in patients undergoing laparoscopic hepatectomy

Shan-Shan Huang; Wei-Wei Lv; Yan-Feng Liu; Shao-Zhong Yang

doi:10.12998/wjcc.v7.i18.2704

Analgesic effect of parecoxib combined with ropivacaine in patients undergoing laparoscopic hepatectomy

World J Clin Cases. 2019 Sep 26;7(18):2704-2711. doi: 10.12998/wjcc.v7.i18.2704.

Authors

Shan-Shan Huang¹, Wei-Wei Lv², Yan-Feng Liu³, Shao-Zhong Yang⁴

Affiliations

¹ Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China.
² Department of Radiology, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China.
³ Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China.
⁴ Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China. yszyang@163.com.

Abstract

Background: Currently, there is no uniform standard for analgesia during laparoscopic hepatectomy. Most of the analgesia schemes adopt epidural analgesia after laparotomy. Although the analgesia is effective, it has a great impact on the recovery of patients after laparoscopic hepatectomy and is not completely suitable for analgesia after laparoscopic hepatectomy. Although multimodal perioperative analgesia can significantly relieve postoperative pain, there is no relevant study of parecoxib combined with ropivacaine for post-laparoscopic hepatectomy analgesia.

Aim: To study the analgesic effect of the preoperative intravenous injection of parecoxib combined with long-acting local anesthetic ropivacaine for incision infiltration in patients undergoing laparoscopic hepatectomy.

Methods: Forty-eight patients undergoing laparoscopic hepatectomy were randomly divided into a combined group (parecoxib combined with ropivacaine) and a control group. The visual analogue scale (VAS) at rest and during movement was used to compare the analgesic effect of the two groups. Meanwhile, the cumulative sufentanil, the recovery time for enterokinesia, the length of postoperative hospital stay, and the adverse reactions (nausea and vomiting) were recorded and compared between the two groups.

Results: The change tendency in VAS scores for both groups was similar after operation. At rest, the VAS scores of the combined group were significantly lower than those of the control group at 0, 6, 12, 24 and 36 h, and during movement, the VAS scores of the combined group were significantly lower than those of the control group at 0, 6, 12, and 24 h. The recovery time for enterokinesia in the combined group was 2.9 d, which was significantly shorter than that in the control group. The cumulative sufentanil in the combined group decreased significantly at 24, 36, and 48 h after operation.

Conclusion: Preoperative intravenous injection of parecoxib combined with ropivacaine for incision infiltration is a simple and effective method for postoperative analgesia in laparoscopic hepatectomy, which could relieve pain and promote recovery.

Keywords: Analgesic effect; Laparoscopic hepatectomy; Parecoxib; Ropivacaine.