USE OF ROPIVACAINE IN ADULTS UNDERGOING PERORAL ENDOSCOPIC MYOTOMY

Currently, peroral endoscopic myotomy (POEM) gains increasingly frequent use for management of esophageal achalasia. Despite POEM being minimally invasive, the problem of the post-operative pain syndrome is still crucial for this type of surgery.

The objective of the study: to compare the degree of pain syndrome in the early post-operative period in different POEM methods.

Methods: 79 patients were divided into 2 groups depending on the solution injected into submucosal tissue in order to provide the safe performance of myotomy. 0.15% solution of ropivacaine was used in Group 1, and 0.9% solution of NaCl in Group 2. The severity of the pain syndrome was compared in all patients using a visual analog scale, as well as consumption of analgesics during first three days after surgery.

Results. On the first post-operative day, the clinically significant pain syndrome was more frequent in Group 2 (p < 0.05). The need in non-steroidal anti-inflammatory drugs did not differ between the groups. On the 2nd day it was observed that the need in NSIAD went down in Group 1 (p < 0.01).

Conclusion. The use of 0.15% solution of ropivacaine as an injection into submucosal tissue during surgery reduces the severity of the pain syndrome and the number of analgesics used in the early post-operative period.

esophageal achalasia, peroral endoscopic myotomy, anesthesia, pain, ropivacaine

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