Methods of postoperative pain treatment and evaluation of the analgesic effect of ropivacaine in local infusions

Postoperative pain, resulting from tissue damage, poses a significant challenge, especially in surgeries involving tissue disruption. Effective management is crucial as uncontrolled pain can hinder rehabilitation, limit mobility, and delay wound healing. Local anesthetics like ropivacaine, administered in continuous local infusions, have gained attention for managing postoperative pain through continuous infusion, targeting sensory nerves over motor nerves. A study at the Orthopedics and Traumatology Clinic of the Medical University in Lublin evaluated ropivacaine’s efficacy in patients undergoing total hip and knee arthroplasty. Total number of 99 patients (38 men, 61 women) were assessed postoperatively in 2018 and 2019. Forty-one patients received 300 ml of 0.25% ropivacaine in continuous infusion at 5 ml/h for 60 hours with on-demand analgesics, while 58 received only conventional analgesics (morphine, ketoprofen, metamizole). Pain management was evaluated over three days post-surgery. All patients required pain management during the initial three days. Ropivacaine patients needed fewer additional analgesics compared to the non-ropivacaine group. For hip arthroplasty with ropivacaine, the average doses of ketoprofen were 3.6, metamizole 3.36, and morphine 2; for knee arthroplasty, the averages were ketoprofen 6, metamizole 2.31, and morphine 1.43. onropivacaine patients had higher doses. Overall, ropivacaine modestly reduced additional pain relief needs. Ropivacaine modestly reduces the demand for additional analgesics postoperatively. Knee surgery required more ketoprofen than hip surgery, with similar requirements for other analgesics in both procedures. Further research is needed to refine pain management strategies and improve postoperative outcomes. Keywords: postoperative pain, ropivacaine, opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), local anesthetics, arthroplasty.