Overlay of a sponge soaked with ropivacaine and multisite infiltration analgesia result in faster recovery after laparoscopic hepatectomy

Table 1 Demographic characteristics of the 140 patients studied (mean ± SD)

Characteristic	Ropivacaine group	Control group	t/χ2	P-value
Age (yr)	52.87 ± 12.463	50.31 ± 13.984	1.126	0.2621
Sex
Male/female	38/31	38/29	38/29	0.8469
Weight (kg)	67.88 ± 11.634	65.75 ± 11.992	1.051	0.2951
ASA grade
I/II/III	8/44/17	12/42/13	1.351	0.5090
Duration of surgery (min)	156.16 ± 82.748	152.75 ± 87.325	0.234	0.8153
Trocar number	4.58 ± 0.715	4.73 ± 0.770	-1.190	-1.190
Incision length (cm)	5.25 ± 1.035	5.45 ± 0.784	-1.276	0.2040
Operation type
Lap right hepatectomy	5	6	5.230	0.1557
Lap left hepatectomy	21	12
Lap caudate hepatectomy	1	5
Lap irregular hepatectomy	42	44

ASA: American Society of Anesthesiologists; Lap: Laparoscopic.

Table 2 Visual analog scale scores for pain at rest and pain on movement, mean arterial pressure, and heart rate during the first 48 h after surgery

Characteristic	0 h	6 h	12 h	24 h	48 h1
VAS at rest
Ropivacaine group	1.94 ± 0.539	1.86 ± 0.493	1.77 ± 0.458	1.54 ± 0.502	1.49 ± 0.504
Control group	1.49 ± 0.504	2.15 ± 0.557	2.03 ± 0.550	1.63 ± 0.487	1.54 ± 0.502
t	-3.155	-3.362	-3.019	-1.068	-0.516
P-value	0.0020	0.0014	0.0030	0.2876	0.6064
95%CI	[-0.523, -0.136]	[-0.478, -0.126]	[-0.461, -0.117]	[-0.258, 0.074]	[-0.233, 0.104]
VAS on movement
Ropivacaine group	2.55 ± 0.631	2.74 ± 0.610	2.65 ± 0.614	2.42 ± 0.579	1.75 ± 0.604
Control group	3.27 ± 0.687	3.70 ± 0.739	3.51 ± 0.660	3.06 ± 0.574	1.97 ± 0.521
t	-6.349	-8.691	-7.991	-6.021	-1.903
P-value	<0.0001	<0.0001	<0.0001	<0.0001	0.0271
95%CI	[-0.942, -0.494]	[-1.192, -0.733]	[-1.071, -0.639]	[-0.835, -0.444]	[-0.408, -0.025]
MAP (mmHg)
Ropivacaine group	90.81 ± 8.432	86.00 ± 8.070	86.07 ± 7.930	87.61 ± 8.037	86.17 ± 9.160
Control group	88.78 ± 8.348	90.54 ± 8.412	89.15 ± 8.504	89.24 ± 9.160	86.28 ± 7.792
t	1.414	-3.210	-2.183	-1.104	-0.075
P-value	0.1596	0.0017	0.0308	0.2716	0.9402
95%CI	[-0.811, 4.882]	[-7.333, -1.742]	[-5.864, -0.289]	[-4.550, 1.290]	[-2.998, 2.779]
HR (bpm)
Ropivacaine group	93.36 ± 4.706	91.57 ± 5.377	91.58 ± 4.120	92.60 ± 5.592	92.63 ± 5.696
Control group	94.42 ± 5.326	93.25 ± 4.427	93.46 ± 5.925	92.81 ± 6.079	92.83 ± 5.828
t	-1.231	-1.991	-2.155	-0.214	-0.202
P-value	0.2204	0.0486	0.0331	0.8308	0.8406
95%CI	[-2.768, 0.644]	[-3.348, -0.011]	[-3.617, -0.146]	[-2.197, 1.768]	[-2.154, 1.756]
Cumulative sufentanil (µg)
Ropivacaine group	0	13.66 ± 2.437	27.91 ± 4.176	55.60 ± 6.117	81.66 ± 7.729
Control group	0	15.43 ± 3.273	30.93 ± 6.414	61.45 ± 5.405	88.89 ± 7.937
t		-3.579	-3.242	-5.897	-5.386
P-value		0.0005	0.0016	<0.0001	<0.0001
95%CI		[-2.744, -0.791]	[-4.863, -1.174]	[-7.803, -3.884]	[-9.891, -4.578]

¹The time point with cumulative sufentanil is 36 h. CI: Confidence interval; VAS: Visual analog scale; MAP: Mean arterial pressure; HR: Heart rate.

Table 3 The levels of stress hormones, including epinephrine, norepinephrine, and cortisol, and cumulative sufentanil consumption during the first 48 h after the operation

Stress hormone	0 h	24 h	48 h
Epinephrine
Ropivacaine group	58.05 ± 19.614	76.48 ± 23.884	81.58 ± 24.529
Control group	57.60 ± 17.608	94.29 ± 28.439	100.89 ± 27.413
t	0.141	-3.959	-4.333
P-value	0.8879	0.0001	<0.0001
95%CI	[-5.876, 6.780]	[-26.707, -8.913]	[-28.131, -10.498]
Norepinephrine
Ropivacaine group	220.57 ± 27.623	252.01 ± 29.539	270.68 ± 30.792
Control group	222.52 ± 27.907	296.90 ± 32.601	322.12 ± 34.942
t	-0.409	-8.421	-9.116
P-value	0.6831	<0.0001	<0.0001
95%CI	[-11.367, 7.470]	[-55.441, -34.351]	[-62.602, -40.280]
Cortisol
Ropivacaine group	325.82 ± 29.790	365.06 ± 35.820	417.79 ± 36.971
Control group	320.74 ± 34.618	393.82 ± 37.302	438.14 ± 40.814
t	0.918	-4.586	-3.048
P-value	0.3600	<0.0001	0.0028
95%CI	[-5.862, 16.025]	[-41.158, -16.356]	[-33.544, -7.145]

CI: Confidence interval.

Table 4 Postoperative hospitalization and complications

Characteristic	Ropivacaine group	Control group	t/χ2	P-value
Hospitalization after operation (d)	7.28 ± 2.502	7.76 ± 2.990	-1.029	0.3055
Postoperative nausea and vomiting
Neither nausea nor vomiting	22	15	1.819	0.4027
Nausea without vomiting	39	41
Nausea with vomiting	8	11
Complication (+/-)
Hydrothorax	25/44	27/40	0.238	0.6256
Ascites	10/59	8/59	0.193	0.6606
Peritonitis	1/68	0/67	0.978	0.3226
Flatulence	32/37	39/28	1.907	0.1673
Venous thrombus	3/66	5/62	0.596	0.4402
Incision infection	2/67	1/66	0.312	0.5768