Comparison of Preoperative and Postoperative Intraperitoneal Nebulised Ropivacaine in Laparoscopic Gastric Bypass: A Randomised Clinical Trial
In brief
Nebulised ropivacaine after surgery lowers shoulder pain at 3 hours
In a randomized trial of 110 gastric-bypass patients, giving ropivacaine by intraperitoneal nebulisation after the operation reduced shoulder pain three hours post-op, while abdominal pain scores and other recovery measures were similar regardless of whether the drug was given before or after surgery. Under a standardized opioid-free regimen overall pain was low, suggesting timing of ropivacaine may be unimportant.
- Journal
- Obesity surgery (Q1)
- Published
- 14 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Maria Cristina Rodriguez Roca, Mercedes Lopez Martinez, Maria Elena Civeira Marín, Maria Recarte Rico, Ramon Corripio Sanchez, Maria Carmen Hernandez Gancedo
- PMID
- 42601513
- DOI
- 10.1007/s11695-026-08893-x
Why clinicians should know about it
- Picked for Surgery (top studies of the week, 16 August 2026).
Abstract
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.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.