[Wound infiltration with bupivacaine following pelviscopy does not reduce postoperative pain intensity. Results of a placebo-controlled, double-blind study].
The analgetic efficacy of intraoperative infiltration with bupivacaine 0.5% or saline of the skin incisions for the endoscopic trocars was examined in 30 female patients following operative endoscopic pelviscopy in a double-blind study. Infiltration of the peritoneum, abdominal wall, and subcutaneously was performed by endoscopic view before skin suture. There were no significant differences between the two groups in age, duration of surgery, operative technique, intensity of preoperative acute and chronic pain, or state of anxiety. Postoperative pain assessment was performed using a numeric rating scale (NRS) hourly within the first 8 h and after 24 h postoperatively. After 8 h patients were asked for the localisation and description of the worst pain. Cumulative tramadol doses were calculated for 3, 8 and 24 h using patient-controlled analgesia (PCA). Pain intensity within the first 8 h postoperatively did not differ between the bupivacaine and placebo groups (Fig. 1). The mean NRS after bupivacaine infiltration was 4.6 (+/- 2.4) in the 1st-3rd h and 3.4 (+/- 1.8) after 6-8 h (placebo: 4.8 (+/- 2) and 2.4 (+/- 1.7)). In both groups most patients reported lower (40%) or upper (12%) abdominal visceral pain as their worst pain. Pain due to skin incision was noted less, but in equal numbers in both groups. Of the patients in the bupivacaine group 77% and in the control group 80% started with PCA due to increasing pain scores within 60 to 120 min. The numbers of tramadol demands and given doses did not differ (Fig. 2).(ABSTRACT TRUNCATED AT 250 WORDS)
Maier
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C
Klinik für Anästhesiologie und Operative Intensivmedizin, Christian-Albrechts-Universität zu Kiel.
Broer-Boos
F
F
Kube
D
D
Arp
W D
WD
D000293:Adolescent; D000328:Adult; D016058:Analgesia, Patient-Controlled; D002045:Bupivacaine / Q000627:therapeutic use*; D004311:Double-Blind Method; D004724:Endoscopy; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D010388:Pelvis / Q000601:surgery*
D002045:Bupivacaine
Eine Wundinfiltration mit Bupivacain bei Pelviskopien hat keinen Einfluss auf die postoperative Schmerzintensität.