Upper abdominal surgery is known to induce such pulmonary complications as pneumonia, atelectasis, pleural effusion. The post operative diaphragmatic dysfunction participates to these complications and lasts for 7 days after upper abdominal surgery. The sniff-test is a recognized tool for measuring the diaphragmatic function.The purpose of this study is to evaluate the effectiveness of parietal analgesia with continuous infiltration of local anesthesic on diaphragmatic function after upper abdominal surgery through a subcostal incision. Our main outcome is to measure the diaphragmatic function with the sniff test in 44 patients with parietal infiltration of ropivacaine and in 44 patients with placebo. Our secondary outcomes are the evaluation of the effect of continuous parietal analgesia with ropivacaine on IPmax and EPmax, oxygen saturation, post operative pulmonary complications and post operative recovery. This prospective study will determine if the pre peritoneal local infiltration of ropivacaine is useful to decrease post operative diaphragmatic dysfunction.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
31
Evaluation of diaphragmatic function by sniff test after continuous parietal infusion of ropivacaine or placebo
20 ml Bolus (7,5 mg/ml) then continuous administration of 10 ml per hour (2 mg/ml) during 48 hours of Ropivacaine. 20 ml Bolus (NaCl 0.9 %) then continuous administration of 10 ml per hour, during 48 hours of NaCl 0.9 %.
Continuous parietal infiltration of Ropivacaine or placebo
Rouen University Hospital
Rouen, France
Buccal Inspiratory Pression (IP) Evaluation of diaphragmatic function using sniff test.
Evaluation of diaphragmatic function using sniff test. The measured value is buccal inspiratory pression.
Time frame: Day 6 post surgery
Maximal buccal inspiratory pression (IPmax) using sniff test
Evaluation of maximal buccal inspiratory pression (IPmax) using sniff test
Time frame: Day 6 after surgical procedure
Maximal buccal expiratory pression (EPmax) using sniff test
Evaluation of maximal buccal expiratory pression (EPmax) using sniff test
Time frame: Day 6 after surgical procedure
Oxygen saturation rate
Evaluation of Oxygen saturation
Time frame: Day 6 after surgical procedure
medical complication outcome (pneumonia)
Medical pulmonary complications outcome : pneumonia
Time frame: week 6 after surgical procedure
medical complication outcome (atelectasis)
Medical pulmonary complications outcome : atelectasis
Time frame: week 6 after surgical procedure
medical complication outcome (pleural effusions)
Medical pulmonary complications outcome : pleural effusions
Time frame: week 6 after surgical procedure
Morphine consummation (Measurement of Morphine consummation since surgery)
Time frame: week 6 after surgical procedure
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