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Local analgesia in laparoscopy: a randomized trial

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Authors
Einarsson, Jon I
Sun, Judy
Orav, John
Young, Amy E
Issue Date
2004

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Citation
Obstet Gynecol 2004, 104(6):1335-9
Abstract
OBJECTIVE: To investigate whether local infiltration of bupivacaine reduces postoperative pain at trocar sites during gynecologic laparoscopy. METHODS: This was a randomized, placebo-controlled, double-blind clinical trial, using patients as their own controls. For each patient, 2 opposite trocar sites were infiltrated. One site was randomly chosen to receive 0.5% bupivacaine, and the other received 0.9% saline. In addition, patients were randomized into 2 cohorts to receive either preincision or postsurgical infiltration. Surgeons, patients, and interviewers were blinded toward the exposure. Postoperative pain was evaluated at 1 hour, 4 hours, and 24 hours after surgery using a 100-mm visual analog scale. Patients rated their pain at each of the infiltrated trocar sites. A 20-mm difference between pain scores was considered clinically significant. A paired t test was used for analysis. RESULTS: Infiltration of bupivacaine at completion of surgery resulted in significantly decreased pain at 1 hour postoperatively (mean pain score 25.8 versus 48.6, P = .02). Mean pain scores at 4 hours and 24 hours were decreased, but not statistically different. Patients receiving bupivacaine before surgery did not have a statistically significant decrease in pain scores. CONCLUSION: Infiltration of bupivacaine at completion of gynecologic laparoscopic surgery decreases pain at trocar sites in the immediate postoperative period.
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http://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=N&PAGE=fulltext&AN=00006250-200412000-00023&LSLINK=80&D=ovft
ae974a485f413a2113503eed53cd6c53
10.1097/01.AOG.0000146283.90934.fd
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