The Analgesic Efficacy of Intraperitoneal Ropivacaine Versus Bupivacaine for Laparoscopic Cholecystectomy: a Meta-Analysis

Abstract

Introduction This meta-analysis aimed to compare the analgesic efficacy of intraperitoneal ropivacaine versus bupivacaine for laparoscopic cholecystectomy.

Methods We searched PubMed, EMbase, Web of Science, EBSCO, and Cochrane Library databases from inception through January 2020 and included randomized controlled trials (RCTs) evaluating the analgesic efficacy of ropivacaine versus bupivacaine for laparoscopic cholecystectomy.

Results Five RCTs are included in the meta-analysis. In patients with laparoscopic cholecystectomy, ropivacaine and bupivacaine demonstrated comparable pain scores at 2 h (SMD = –0.22; 95% CI = –0.54 to 0.10; p = 0.18), 4 h (SMD = –0.16; 95% CI = –0.42 to 0.10; p = 0.22), 8 h (SMD = –0.60; 95% CI = –1.19 to –0.01; p = 0.05), and 24 h (SMD = 0.33; 95% CI = –1.19 to 1.84; p = 0.67), as well as time to first analgesic requirement (SMD = 0.10; 95% CI = –0.23 to 0.42; p = 0.56).

Conclusions Intraperitoneal ropivacaine and bupivacaine have a similar analgesic efficacy for laparoscopic cholecystectomy.

Zusammenfassung

Einleitung Ziel dieser Meta-Analyse war der Vergleich der analgetischen Wirksamkeit von intraperitonealem Ropivacain gegenüber Bupivacain bei der laparoskopischen Cholezystektomie.

Methoden Wir durchsuchten PubMed, EMbase, Web of Science, EBSCO, und Cochrane Library Datenbanken im Januar 2020 und schlossen randomisierte kontrollierte Studien (RCTs), die die analgetische Wirksamkeit von Ropivacain gegenüber Bupivacain bei der laparoskopischen Cholezystektomie untersuchten mit ein.

Ergebnisse Fünf RCTs wurden in die Meta-Analyse einbezogen. Bei Patienten mit laparoskopischer Cholezystektomie zeigten Ropivacain und Bupivacain vergleichbare Schmerzwerte nach 2 h (SMD = –0,22; 95% CI = –0,54 bis 0,10; p = 0,18), 4 h (SMD = –0,16; 95% CI = –0,42 bis 0,10; p = 0,22), 8 h (SMD = –0,60; 95% CI = –1,19 bis –0,01; p = 0,05), und 24 h (SMD = 0,33; 95% CI = –1,19 bis 1,84; p = 0,67), sowie die Zeit bis zum ersten Analgetika (SMD = 0,10; 95% CI = –0,23 to 0,42; p = 0,56).

Schlussfolgerungen Intraperitoneales Ropivacain und Bupivacain haben eine ähnliche analgetische Wirksamkeit bei der laparoskopischen Cholezystektomie.

Schlüsselwörter

endovaskuläre Therapie - interventionelle Endoskopie - minimal residual disease

Keywords

endoscopic surgery - laparoscopic surgery - liver surgery

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