As per a study published in The Canadian Journal of Surgery, no additional clinical benefit of intraperitoneal local anesthesia (IPLA) with ropivacaine was reported in individuals undergoing elective bariatric surgery with an established enhanced recovery after bariatric surgery (ERABS) protocol.

In this prospective, double-blind, randomized controlled pilot study, investigators aimed to determine the clinical efficacy of adding IPLA to a standardized ERABS protocol for controlling pain and enhancing functional outcomes during bariatric surgery.

This study included people scheduled for laparoscopic Roux-en-Y gastric bypass surgery (LRYGB) in the setting of a standardized ERABS protocol. Overall, 100 participants were randomized to receive either normal saline (control group, n=50) or IPLA with 0.2% ropivacaine (intervention group, n=50).

Analgesic intake, adverse effects, and pain scores were estimated. The functional prehabilitation endpoints, including six Minute Walk Test (6MWT), Quality of Recovery Survey-40 (QoR-40) scores, and peak expiratory flow (PEF) were evaluated prior to surgery, and one day and seven days after surgery.

In total, 92 subjects finished the study with 46 subjects in each group. No profound differences were noted between the two groups in baseline characteristics or any secondary or primary outcomes. Pain scores (Table 1) and analgesic intake were low in both groups. 

No adverse events were noted. In both groups, a considerable drop in PEF and 6MWT and QoR-40 scores were witnessed on the first day after surgery. The standardization of the ERABS protocol benefited participants, with functional prehabilitation values returning to baseline on postsurgery day 7 in both groups. Therefore, there is a need for substitute methods to alleviate pain following bariatric surgery.