Pre-incisional Infiltration With Ropivacaine Plus Diprospan for Relieving Postoperative Pain After Laparoscopic Surgery
The Efficacy and Safety of Pre-incisional Infiltration With Ropivacaine Plus Diprospan in Patients Undergoing Laparoscopic Surgery: a Multi-center Randomized Controlled Trial.
Incisional infiltration is the simplest, safest, and most effective anesthesia method for preventing incision pain after laparoscopic surgery, but even using long-acting local anesthetics, the effectiveness of postoperative analgesia can only last for a relatively short period of time. Studies have shown that up to 80% of patients experience postoperative pain following laparoscopic surgery due to inflammation caused by surgical incisions and surrounding tissues, necessitating pharmacological relief. Inflammatory mediators released from the soft tissues around laparoscopic incisions not only significantly alters the chemical microenvironment at the peripheral terminals of nociceptors, directly inducing pain, but also sensitizes afferent fibers, contributing to peripheral sensitization.
Numerous studies have shown that glucocorticoids not only can achieve anti-inflammatory and analgesic effects by inhibiting inflammatory cytokines and inflammatory responses but also can prolong the duration of action of local anesthetics. Preemptive incisional infiltration using local anesthetics with corticosteroids which have potent local anti-inflammatory properties may play a key role in preventing or reducing postoperative pain. The objective of this trial is to determine whether preemptive incisional infiltration with ropivacaine plus diprospan is superior to ropivacaine alone in relieving postoperative pain for adults undergoing laparoscopic surgery. The investigators also compare the effects of the two intervention measures on postoperative pain management, patient safety, and recovery quality.
研究概览
地位
研究类型
注册 (估计的)
阶段
- 不适用
联系人和位置
学习联系方式
- 姓名：Fang Luo
- 电话号码：+86 13611326978
- 邮箱：13611326978@163.com
学习地点
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Beijing Municipality
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Beijing、Beijing Municipality、中国、100070
- 招聘中
- Beijing Tiantan Hospital
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接触：
- Fang Luo
- 电话号码：+86 13611326978
- 邮箱：13611326978@163.com
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参与标准
资格标准
适合学习的年龄
- 成人
接受健康志愿者
描述
Inclusion Criteria:
- Patients scheduled for elective Laparoscopic Surgery for laparoscopic cholecystectomy, appendectomy, or hernia repair under general anesthesia;
- Ages 18 to 64 years old;
- American Society of Anesthesiologists (ASA) physical status of I-III;
- Patients must be able to understand nature and potential personal; consequences of the clinical trial and cooperation with follow-up investigations;
- signing of the informed consent form.
Exclusion Criteria:
- History of allergies to experimental drugs such as opioids or steroids;
- Alcohol abuse; Long term use of opioid drugs (exceeding 2 weeks or 3 days per week for more than 1 month); Suspected use of sedatives and analgesics;
- Use analgesic drugs within 24 hours before surgery;
- Patients undergoing steroid therapy;
- Serious neurological disorders, severe liver and kidney dysfunction, heart failure, etc;
- Unable to use pain assessment scale;
- Pregnant or lactating patients.
学习计划
研究是如何设计的？
设计细节
- 主要用途：预防
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：四人间
武器和干预
参与者组/臂 |
干预/治疗 |
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有源比较器：Pre-incisional infiltration with ropivacaine alone
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Before the surgery, according to the surgeon's incision marking, the patients accept 30ml of 0.5% ropivacaine infiltrates the incision layer by layer (1ml subcutaneous infiltration at each location, 2ml full layer infiltration, total 3ml).
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实验性的：Pre-incisional infiltration with ropivacaine plus diprospan
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Before the surgery, according to the surgeon's incision marking, the patients accept 0.5ml of diprospan (1ml diprospan: Betamethasone Dipropionate 5mg and Betamethasone Sodium Phosphate 2mg) plus 15ml of 1% ropivacaine diluted with 0.9% saline to a total volume of 30ml infiltrates the incision layer by layer (1ml subcutaneous infiltration at each location, 2ml full layer infiltration, total 3ml).
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研究衡量的是什么？
主要结果指标
结果测量 |
大体时间 |
|---|---|
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Intravenous Morphine Equivalents of Rescue Analgesic Medications Within 48 Hours Postoperatively
大体时间：The postoperative period 48 hours
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The postoperative period 48 hours
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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术后1周、1个月和3个月的静息数字评定量表（NRSr）
大体时间：术后第7天、第1个月和第3个月。
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数字评分量表（NRS）将0定义为无疼痛，10定义为最剧烈疼痛；1-3分表示轻度疼痛，4-6分表示中度疼痛，7-10分表示重度疼痛。
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术后第7天、第1个月和第3个月。
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Adverse events
大体时间：Within 72 hours postoperatively
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Including local anesthetic poisoning, local hematoma, nausea and vomiting, itching, hypotension, arrhythmia, delirium, etc; Abnormal values in clinical laboratory tests, such as elevated blood glucose levels.
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Within 72 hours postoperatively
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Area under the curve (AUC) of the Numerical Rating Scale during movement (NRSm) within 0-72 hours postoperatively
大体时间：Data will be collected at 4、12、24、36 and 72 hours postoperatively
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The Numeric Rating Scale (NRS) designates 0 as representing no pain and 10 as representing the most severe pain, scores of 1-3 indicate mild pain, 4-6 denote moderate pain, and 7-10 signify severe pain.
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Data will be collected at 4、12、24、36 and 72 hours postoperatively
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Patient Satisfaction Scale(PSS)
大体时间：Postoperative hours 4、12、24 and 48 hours
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Patient Satisfaction Scale(PSS) on a scale ranging from 0 to 10, where 0 denotes "completely dissatisfied" and 10 signifies "extremely satisfied".
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Postoperative hours 4、12、24 and 48 hours
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Postoperative nausea and vomiting (PONV)
大体时间：Postoperatively within 48 hours
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Measured on a scale of 0-3: 0 indicates no nausea, 1 indicates mild nausea that does not require treatment, 2 indicates nausea that requires treatment, and 3 indicates vomiting.
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Postoperatively within 48 hours
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Wound healing score
大体时间：Postoperative 72 hours、1 and 3 months
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The wound healing score is evaluated by independent researchers based on the wound healing score table, which includes three aspects: skin healing, incision infection, and hair growth.
The total score is obtained by adding up the three scores.
Excellent wound healing: 3 points; Good wound healing is 4-5; Poor wound healing: total score greater than or equal to 6 points.
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Postoperative 72 hours、1 and 3 months
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Postoperatively and patient and observer scar assessment scale
大体时间：Postoperative 72 hours、1 and 3 months
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Postoperatively and patient and observer scar assessment scale: the observer scores the scar based on the distribution of blood vessels around the incision, color, scar thickness, surface roughness, area, and softness.
Each score ranges from 1 to 10 points and higher scores indicating more severe scars; The patient evaluates the scar based on whether there is pain or itching, color, softness, thickness, and self-perception.
Each score range is also 1-10 points, with 1 point indicating no difference from normal skin and a higher score indicating more severe scars.
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Postoperative 72 hours、1 and 3 months
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Area Under the Curve (AUC) of Numeric Rating Scale at rest (NRSr) Within 0-72 Hours Postoperatively
大体时间：Data will be collected at 4、12、24、36 and 72 hours postoperatively
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Description: scores of 1-3 indicate mild pain, 4-6 denote moderate pain, and 7-10 signify severe pain
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Data will be collected at 4、12、24、36 and 72 hours postoperatively
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合作者和调查者
研究记录日期
研究主要日期
学习开始 (估计的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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