Effect of local wound infiltration with ropivacaine on postoperative pain relief and stress response reduction after open hepatectomy

Table 1 Demographic characteristics of the patients studied (mean ± SD)

Characteristic	Ropivacaine group	Control group	t/χ2	P value
Age (yr)	48.38 ± 11.74	49.59 ± 12.42	-0.36	0.7176
Gender
Male/female	18/8	18/9	0.04	0.8415
Weight (kg)	63.04 ± 9.21	66.04 ± 9.86	-1.14	0.2583
ASA grade
I/II/III	4/17/5	7/15/5	0.92	0.6298
Incision length (cm)	24.65 ± 1.83	24.22 ± 2.76	0.67	0.5075
Operation type
Left hepatectomy	8	5		0.0086
Right hepatectomy	13	8
Mesohepatectomy	1	0
Caudate lobectomy	2	1
Irregular hepatectomy	2	13
Postoperative pathology
Hepatocellular carcinoma	22	18		0.3292
Intra-and extrahepatic cholangiolithiasis	3	7
Hepatic focal nodular hyperplasia	1	1
Hepatocellular adenoma	0	1

ASA: American Society of Anesthesiologists.

Table 2 Visual analog scale scores at rest and on movement, mean arterial pressure, heart rate, and cumulative sufentanil consumption

Characteristic	0 h	6 h	12 h	24 h	48 h1
VAS at rest
Ropivacaine group	2.38 ± 0.50	2.27 ± 0.45	2.04 ± 0.20	2.12 ± 0.33	2.08 ± 0.27
Control group	2.78 ± 0.58	2.67 ± 0.48	2.48 ± 0.51	2.22 ± 0.42	2.15 ± 0.36
t	-2.65	-3.17	-4.21	-1.03	-0.81
P value	0.0106	0.0032	0.0002	0.3096	0.4230
VAS on movement
Ropivacaine group	3.27 ± 0.53	3.35 ± 0.63	3.31 ± 0.62	3.23 ± 0.43	3.11 ± 0.52
Control group	3.63 ± 0.56	3.85 ± 0.60	3.78 ± 0.64	3.41 ± 0.57	3.30 ± 0.47
t	-2.39	-2.99	-2.72	-1.27	-1.34
P value	0.0208	0.0043	0.0089	0.2110	0.1857
MAP (mmHg)
Ropivacaine group	95.88 ± 5.08	93.35 ± 4.63	92.62 ± 4.43	94.73 ± 4.16	93.19 ± 3.41
Control group	97.74 ± 4.17	96.15 ± 4.14	97.56 ± 4.23	98.37 ± 3.99	94.89 ± 3.90
t	-1.46	-2.32	-4.16	-3.25	-1.69
P value	0.1515	0.0241	0.0001	0.0020	0.0981
HR (bpm)
Ropivacaine group	88.96 ± 4.12	90.19 ± 3.92	89.73 ± 4.45	91.65 ± 4.30	90.31 ± 4.45
Control group	92.04 ± 4.27	93.41 ± 4.62	94.74 ± 3.88	94.56 ± 3.43	92.11 ± 4.05
t	-2.66	-2.73	-4.37	-2.72	-1.54
P value	0.0103	0.0087	< 0.0001	0.0089	0.1289
Cumulative sufentanil consumption (μg)
Ropivacaine group	0	14.94 ± 2.56	30.40 ± 5.39	56.75 ± 6.20	83.02 ± 7.05
Control group	0	17.06 ± 3.81	35.50 ± 6.91	65.31 ± 7.09	91.39 ± 7.34
t		-2.36	-2.99	-4.67	-4.23
P value		0.0220	0.0043	< 0.0001	< 0.0001

¹As to cumulative sufentanil consumption, the time point was set at 36 h. VAS: Visual analog scale; MAP: Mean arterial pressure; HR: Heart rate.

Table 3 Plasma concentrations of epinephrine, norepinephrine and cortisol (pg/mL)

Stress hormone	0 h	24 h	48 h
Epinephrine
Ropivacaine group	64.19 ± 19.62	86.54 ± 28.64	94.27 ± 30.10
Control group	66.19 ± 20.30	110.26 ± 31.88	118.59 ± 33.65
t	-0.36	-2.85	-2.77
P value	0.7180	0.0064	0.0078
Norepinephrine
Ropivacaine group	251.31 ± 30.19	280.62 ± 34.22	310.12 ± 35.15
Control group	259.70 ± 31.72	361.00 ± 36.06	390.41 ± 37.73
t	-0.99	-8.32	-8.01
P value	0.3286	< 0.0001	< 0.0001
Cortisol
Ropivacaine group	342.00 ± 33.72	391.81 ± 36.53	450.62 ± 39.39
Control group	331.59 ± 31.92	487.48 ± 34.36	518.85 ± 38.21
t	1.15	-9.82	-6.40
P value	0.2537	< 0.0001	< 0.0001

Table 4 Time to bowel recovery, postoperative nausea and vomiting, and hospitalization length in the two groups

Characteristic	Ropivacaine group	Control group	t/χ2	P value
Time to bowel recovery (d)	3.15 ± 1.01	3.93 ± 1.17	-2.56	0.0133
PONA
No PONA	7	3		0.2729
Nausea without vomiting	16	18
Nausea with vomiting	3	6
Hospitalization (d)	8.65 ± 2.43	10.52 ± 3.49	-2.25	0.0289

PONA: Postoperative nausea and vomiting.