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Anesthesia and Pain Medicine 2013;8(4):216-221.
Published online October 30, 2013.
Use of the On-Q system for pain management after robot - assisted endoscopic transaxillary thyroidectomy
Woo Young Park, Ki Jun Kim, Kyoung Tae Min, Seung Ho Choi, Sung Jin Lee, Woong Youn Chung
1Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.
2Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea. kkj6063@yuhs.ac
3Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Abstract
BACKGROUND
The robot-assisted transaxillary approach to thyroid surgery is a novel method that has recently been used to improve patient safety and cosmetic outcomes. We evaluated post-operative pain, following robot-assisted endoscopic transaxillary thyroid surgery, and pain relief using a continuous wound perfusion system with local anesthetics.
METHODS
In a control group of 25 female patients who underwent robot-assisted endoscopic transaxillary thyroidectomy, the post-operative pain scores and characteristics as well as analgesic use were monitored. Fifty female patients undergoing robot-assisted endoscopic transaxillary thyroidectomy were given the On-Q system. They were then randomly assigned to receive one of two different local anesthetic doses: Group I (0.25% Ropivacaine, n = 25); and Group II (0.375% Ropivacaine, n = 25). The pain score, pain site, analgesic requirements and side effects of each group were recorded during the 48 hour period post-surgery.
RESULTS
Post-operative pain scores and analgesic demand were lower in the On-Q groups than in the control group. No difference was found between Group I and Group II. Until 6-12 hours after surgery, pain was mainly located in the axilla, while after 6-12 hours, the primary location of pain had a tendency to move to the neck. Pain scores gradually decreased in time for all patients.
CONCLUSIONS
Patients who underwent robot-assisted endoscopic transaxillary thyroidectomy with an On-Q system injecting 0.25% ropivacaine had lower pain scores, showing the effectiveness of the system. As a potential pain blocker, continuous wound perfusion with the On-Q system attenuates side effects. This could lead to shortened hospital stays after robot-assisted endoscopic transaxillary thyroidectomy.
Key Words: Local anesthetics, Pain relief, Robotics, Subcutaneous infusion, Thyroidectomy
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