Comparison of Preoperative and Postoperative Intraperitoneal Nebulised Ropivacaine in Laparoscopic Gastric Bypass: A Randomised Clinical Trial.
Maria Cristina Rodriguez Roca, Mercedes Lopez Martinez, Maria Elena Civeira Marín et al.
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In 30 seconds
This randomised clinical trial compared preoperative with postoperative intraperitoneal nebulised ropivacaine in 110 patients undergoing laparoscopic gastric bypass. Pain was assessed at multiple postoperative intervals, alongside analgesic use and other recovery outcomes. The groups did not differ significantly in abdominal pain scores or secondary outcomes, with one exception: shoulder pain was lower 3 hours after surgery in the postoperative nebulisation group. Under the study’s standardised opioid-free anaesthesia protocol, postoperative pain was minimal, and the authors concluded that administration timing did not appear relevant.
Key findings
- Among 110 patients, abdominal pain scores did not differ significantly between preoperative and postoperative nebulisation groups.
- Shoulder pain was lower 3 hours postoperatively with postoperative nebulisation.
- No significant between-group differences were observed in analgesic consumption or other reported secondary outcomes.
Why it matters
The findings suggest that, within a standardised opioid-free anaesthesia protocol for laparoscopic gastric bypass, changing the timing of intraperitoneal ropivacaine may not meaningfully alter postoperative pain or recovery outcomes. The isolated shoulder-pain difference at 3 hours should be interpreted alongside the otherwise similar outcomes and does not establish a broader advantage for either timing strategy.
What to keep in mind
The abstract does not report the magnitude of the shoulder-pain difference or provide further detail on follow-up beyond the postoperative assessment intervals.