Preemptive local anaesthetic in gynecological laparoscopy and postoperative movement evoked pain : a randomised trial

Ravndal, Caroline and Vandrevala, Tushna (2016) Preemptive local anaesthetic in gynecological laparoscopy and postoperative movement evoked pain : a randomised trial. Journal of Minimally Invasive Gynecology, 23(5), pp. 775-780. ISSN (print) 1553-4650

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Abstract

STUDY OBJECTIVE: To evaluate whether preemptive local anesthetics injected into the trocar areas reduce postoperative movement-evoked pain within an enhanced recovery program (ERP) in laparoscopic gynecologic surgery. DESIGN: A randomized and double-blinded trial with parallel assignments (Canadian Task Force Classification I). SETTING: The study was conducted in the gynecologic department at the University Hospital of Stavanger, Stavanger, Norway. PATIENTS: Twenty-four women eligible for elective laparoscopic surgery for a benign indication within an ERP were included. INTERVENTIONS: The women were randomized to preemptive local injections of either 0.5% bupivacaine (intervention group) or 0.9% saline (control group) at each trocar site. MEASUREMENTS AND MAIN RESULTS: The primary outcome measure of the study was movement-evoked pain 5 hours after surgery. The secondary outcome measures were pain at rest 2 and 5 hours after surgery and the use of rescue analgesics during the postoperative period. Pain was measured on a numeric rating scale of 0 to 10. Data were treated to a per-protocol analysis, and a p < .05 was considered significant. RESULTS: Twenty-three women completed the trial. The median score for movement-evoked pain 5 hours after surgery was significantly lower in the intervention group (1 vs. 3, p = .044). There was no difference in pain at rest after 2 and 5 hours and no difference in the requirement for rescue analgesics. CONCLUSION: Preemptive local anesthetics in the trocar areas are shown to be beneficial in laparoscopic gynecologic surgery within an enhanced recovery program. Movement-evoked pain is far more intense than pain at rest.

Item Type: Article
Research Area: Other hospital based clinical subjects
Faculty, School or Research Centre: Faculty of Arts and Social Sciences (until 2017)
Faculty of Arts and Social Sciences (until 2017) > School of Psychology, Criminology and Sociology (from November 2012)
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Depositing User: Susan Miles
Date Deposited: 13 Apr 2016 07:53
Last Modified: 14 Sep 2017 14:12
DOI: https://doi.org/10.1016/j.jmig.2016.03.009
URI: http://eprints.kingston.ac.uk/id/eprint/34804

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