Failure of meperidine wound infiltration to reduce pain after laparoscopic tubal ligation.
Many women experience considerable pain and delay in return to regular activity after laparoscopic tubal ligation. We performed a prospective randomized double-blind study to evaluate pain and recovery after laparoscopic tubal ligation and the influence of meperidine wound infiltration. After approval by the Ethics Committee, informed consent was obtained from 60 patients. All patients received naproxen 500 mg po one hour before surgery. Patients were randomized into three groups. All patients received a standard general anaesthetic. Group C patients (n = 18) received normal saline (NS) in the deltoid and NS in the wound. Group S patients (n = 21) received 50 mg of meperidine in the deltoid and NS in the wound. Group W patients (n = 21) received 50 mg meperidine in the wound and NS in the deltoid. After surgery, pain and nausea were treated with morphine and metoclopramide as needed. Following hospital discharge, patients were contacted by telephone daily until they returned to regular activities. The mean maximum pain score of Group S patients was lower than that of Group C patients (P < 0.05). Group S patients required less morphine in the Postanaesthesia Care Unit than the Group C patients (P < 0.05). One Group C patient was readmitted to hospital due to inadequate analgesia with oral medications. Group S patients returned to regular activity earlier than the Group C patients (P < 0.05). It is concluded that wound infiltration with meperidine did not affect postoperative pain or recovery. Intramuscular administration of the same amount of meperidine resulted in less postoperative pain and earlier return to regular activity.
Forgach
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Department of Anaesthesia, University of Manitoba, Winnipeg, Canada.
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D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000493:pharmacokinetics*; D000704:Analysis of Variance; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D007273:Injections, Intramuscular; D010535:Laparoscopy; D008614:Meperidine / Q000008:administration & dosage / Q000493:pharmacokinetics*; D009288:Naproxen / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy* / Q000378:metabolism; D011446:Prospective Studies; D013246:Sterilization, Tubal; D014018:Tissue Distribution; D014947:Wounds and Injuries / Q000378:metabolism*
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D009288:Naproxen; D008614:Meperidine