BACKGROUND Advanced-stage ovarian cancer has a poor prognosis; surgical resection with the intent to leave no residual tumour followed by adjuvant chemotherapy is the standard treatment. Local anaesthetics (LA) have anti-inflammatory and analgesic effects. We hypothesised that intraperitoneal LA (IPLA) would lead to improved postoperative recovery, better pain relief, and earlier start of chemotherapy. METHODS This was a prospective, randomised, double-blind, placebo-controlled pilot study in 40 women undergoing open abdominal cytoreductive surgery. Patients were randomised to receive either intraperitoneal ropivacaine (Group IPLA) or saline (Group Placebo) perioperatively. Except for study drug, patients were treated similarly. Intraoperatively, ropivacaine 2 mg ml-1 or 0.9% saline was injected thrice intraperitoneally, and after operation via a catheter and analgesic pump into the peritoneal cavity for 72 h. Postoperative pain, time to recovery, home discharge, time to start of chemotherapy, and postoperative complications were recorded. RESULTS No complications from LA administration were recorded. Pain intensity and rescue analgesic consumption were similar between groups. Time to initiation of chemotherapy was significantly shorter in Group IPLA (median 21 [inter-quartile range 21-29] vs 29 [inter-quartile range 21-40] days; P=0.021). Other parameters including time to home readiness, home discharge and incidence, and complexity of postoperative complications were similar between the groups. CONCLUSIONS Intraperitoneal ropivacaine during and for 72 h after operation after cytoreductive surgery for ovarian cancer is safe and reduces the time interval to initiation of chemotherapy. Larger studies are warranted to confirm these initial findings. CLINICAL TRIAL REGISTRATION NCT02256228.

中文翻译：

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腹腔罗哌卡因可减少晚期卵巢癌手术后开始化疗的时间间隔：随机对照双盲试验研究。

背景晚期卵巢癌预后较差。旨在不留下任何残留肿瘤，然后进行辅助化疗的手术切除是标准治疗方法。局部麻醉药（LA）具有抗炎和镇痛作用。我们假设腹膜内LA（IPLA）会导致术后恢复改善，疼痛缓解和早期化疗开始。方法这是一项前瞻性，随机，双盲，安慰剂对照的前瞻性研究，研究对象是40位接受开腹减瘤术的女性。患者随机接受围手术期接受腹膜内罗哌卡因（IPLA组）或生理盐水（安慰剂组）的治疗。除研究药物外，患者的治疗情况相似。术中三次腹膜内注射罗哌卡因2 mg ml-1或0.9％生理盐水，手术后通过导管和止痛泵进入腹膜腔72小时。记录术后疼痛，恢复时间，出院时间，开始化疗的时间以及术后并发症。结果没有记录到LA给药引起的并发症。两组之间的疼痛强度和急救镇痛剂的消耗量相似。IPLA组开始化疗的时间显着缩短（中位21 [四分位间距21-29]天比29 [四分位间距21-40]天； P = 0.021）。两组之间的其他参数包括上班准备时间，出院和发病率以及术后并发症的复杂性。结论卵巢癌减瘤手术后及手术后72 h腹腔罗哌卡因安全，可缩短开始化疗的时间间隔。有必要进行更大规模的研究以确认这些初步发现。临床试验注册NCT02256228。