Comparison of Preoperative and Postoperative Intraperitoneal Nebulised Ropivacaine in Laparoscopic Gastric Bypass: A Randomised Clinical Trial.

BACKGROUND: Intraperitoneal administration of local anaesthetics (IPLA) is commonly used in laparoscopic surgery as part of multimodal analgesia. METHODS: This CT included 110 patients. Patients were randomly assigned to receive nebulised ropivacaine either before or after surgery. Pain was assessed using the Visual Analogue Scale (VAS) at multiple postoperative intervals. Secondary outcomes included analgesic consumption, shoulder pain, oral intake tolerance, early mobilisation, and incidence of nausea and vomiting. RESULTS: No significant differences were observed in abdominal pain scores or any of the secondary outcomes between groups, except for reduced shoulder pain 3 hours postoperatively in the postoperative nebulisation group. CONCLUSION: Under a standardised opioid-free anaesthesia protocol, postoperative pain was minimal and substantially lower than expected. Therefore, the timing of intraperitoneal ropivacaine administration does not appear to be relevant.