Ropivacaine effect on hemostasis and pain level in patients undergoing orthognathic surgery: a triple-blinded, randomized, clinical trial.

IF 4.6 2区医学 Q2 IMMUNOLOGY

Inflammopharmacology Pub Date : 2025-03-15 DOI:10.1007/s10787-025-01716-y

Majid Hosseini-Abrishami, Mozhgan Kazemian, Mohammad Javad Sedaghati, Mohammad Alipour, Melika Hoseinzadeh, Alireza Ghaffarian-Hosseini, Vahid Reza Askari

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Abstract

Objective: This triple-blind, controlled clinical trial aimed to assess the effects of ropivacaine and lidocaine on hemodynamic factors, blood loss, opioid consumption, and postoperative pain in patients undergoing orthognathic surgery.

Methods: Thirty-two patients with Class III malocclusion scheduled for orthognathic surgery were included. The participants were randomly assigned to receive 0.5% ropivacaine or 2% lidocaine with 1:80,000 epinephrine for local anesthesia (n = 16). Hemodynamic parameters were recorded at various time intervals, which included heart rate (HR), systolic blood pressure, diastolic blood pressure, mean arterial pressure, oxygen saturation (SpO₂), intraoperative bleeding, opioid consumption, and postoperative pain intensity.

Results: The participants' mean age was 23.67 ± 4.56 years, and 75% were female. The groups were comparable in most measured outcomes. HR was significantly higher in the ropivacaine group at 30 and 60 min post-injection (P < 0.05). SpO₂ percentages were comparable between the groups, except at 15 min post-anesthesia, where the lidocaine group demonstrated a significantly higher SpO₂ (P = 0.029). Blood pressure, postoperative opioid consumption, intraoperative bleeding, and postoperative pain levels showed no statistically significant differences between the two groups.

Conclusion: Within the limitations of this study, both 0.5% ropivacaine and lidocaine with epinephrine demonstrated comparable effects on hemodynamic stability, intraoperative blood loss, postoperative pain levels, and opioid consumption in patients undergoing orthognathic surgery. These findings suggest that ropivacaine may serve as a safe and effective alternative to lidocaine for local anesthesia in orthognathic procedures.

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罗哌卡因对正颌手术患者止血和疼痛水平的影响：一项三盲、随机、临床试验

目的：本三盲对照临床试验旨在评估罗哌卡因和利多卡因对正颌手术患者血流动力学因素、失血、阿片类药物消耗和术后疼痛的影响。方法：对32例拟行正颌手术的III类错颌患者进行分析。16例受试者随机接受0.5%罗哌卡因或2%利多卡因加1:8万肾上腺素局部麻醉。记录不同时间间隔的血流动力学参数，包括心率（HR）、收缩压、舒张压、平均动脉压、血氧饱和度（SpO2）、术中出血、阿片类药物消耗和术后疼痛强度。结果：患者平均年龄23.67±4.56岁，女性占75%。两组在大多数测量结果上具有可比性。罗哌卡因组在注射后30min和60min的SpO2明显高于对照组(两组间的SpO2百分比相当，但在麻醉后15min，利多卡因组SpO2明显高于对照组（P = 0.029）。血压、术后阿片类药物用量、术中出血和术后疼痛水平在两组间无统计学差异。结论：在本研究的限制范围内，0.5%罗哌卡因和利多卡因加肾上腺素对正颌手术患者的血流动力学稳定性、术中出血量、术后疼痛水平和阿片类药物消耗的影响相当。这些发现表明，在正颌手术中，罗哌卡因可作为一种安全有效的局部麻醉替代利多卡因。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Inflammopharmacology IMMUNOLOGYTOXICOLOGY-TOXICOLOGY

CiteScore

8.00

自引率

3.40%

发文量

200

期刊介绍： Inflammopharmacology is the official publication of the Gastrointestinal Section of the International Union of Basic and Clinical Pharmacology (IUPHAR) and the Hungarian Experimental and Clinical Pharmacology Society (HECPS). Inflammopharmacology publishes papers on all aspects of inflammation and its pharmacological control emphasizing comparisons of (a) different inflammatory states, and (b) the actions, therapeutic efficacy and safety of drugs employed in the treatment of inflammatory conditions. The comparative aspects of the types of inflammatory conditions include gastrointestinal disease (e.g. ulcerative colitis, Crohn''s disease), parasitic diseases, toxicological manifestations of the effects of drugs and environmental agents, arthritic conditions, and inflammatory effects of injury or aging on skeletal muscle. The journal has seven main interest areas: -Drug-Disease Interactions - Conditional Pharmacology - i.e. where the condition (disease or stress state) influences the therapeutic response and side (adverse) effects from anti-inflammatory drugs. Mechanisms of drug-disease and drug disease interactions and the role of different stress states -Rheumatology - particular emphasis on methods of measurement of clinical response effects of new agents, adverse effects from anti-rheumatic drugs -Gastroenterology - with particular emphasis on animal and human models, mechanisms of mucosal inflammation and ulceration and effects of novel and established anti-ulcer, anti-inflammatory agents, or antiparasitic agents -Neuro-Inflammation and Pain - model systems, pharmacology of new analgesic agents and mechanisms of neuro-inflammation and pain -Novel drugs, natural products and nutraceuticals - and their effects on inflammatory processes, especially where there are indications of novel modes action compared with conventional drugs e.g. NSAIDs -Muscle-immune interactions during inflammation [...]