Site Editor
Joyce F. Liu, MD, MPH
Joyce F. Liu, MD, MPH
Posted: Tuesday, January 21, 2025
Emma Hasselgren, MD, PhD, of Karolinska University Hospital, Stockholm, and colleagues conducted a phase III trial investigating the use of intraperitoneal ropivacaine in advanced ovarian cancer surgery. Despite promising results from a prior phase II study, the investigators found no significant benefit with the local anesthetic in shortening the time to return to intended oncologic therapy, a measure linked to improved survival outcomes. Their findings were published in the British Journal of Anaesthesia.
This double-blind, phase III superiority trial was conducted in Sweden at two university hospitals, involving women with advanced ovarian cancer scheduled for cytoreductive surgery. Eligible participants were randomly assigned to receive either intraperitoneal ropivacaine at 0.2% or saline (placebo) during and after surgery. The primary endpoint was the time to return to intended oncologic treatment, with analyses adjusted for site differences.
Between August 2020 and December 2023, 225 women were randomly assigned to receive ropivacaine (n =113) and placebo (n= 112), with 175 included in the modified intention-to-treat analysis. The median ages of participants were comparable between the groups. The mean return to intended oncologic therapy was 26.5 days with ropivacaine vs 25.8 days with placebo, resulting in a nonsignificant mean difference of 0.7 days (95% confidence interval [CI] = −2.2 to 3.4 days; P = .65). Per-protocol analysis of 166 women also showed no meaningful difference, with a mean difference of 0.5 days (95% CI = −2.4 to 3.4 days; P = .74). Additionally, no differences were observed in short-term recovery metrics or postoperative morbidity rates, according to the study authors. Furthermore, they reported no evidence with the local anesthetic in reduction of postoperative analgesic consumption or pain.
Thus, the findings of this larger trial highlight the need for alternative strategies to expedite postoperative recovery in this patient population.
Disclosure: The study authors reported no conflicts of interest.
British Journal of Anaesthesia
