Pain control after microlaparoscopy.
OBJECTIVE
To evaluate the efficacy of intraperitoneal subdiaphragmatic instillation of 0.5% lidocaine and 0.5% bupivacaine infiltration of cannula sites to control pain after diagnostic microlaparoscopy.


METHODS
Prospective, randomized study. (Canadian Task Force classification I).


METHODS
Day surgery unit of Endogyn Service, Private Endoscopic Associates, Naples, and Department of Gynecologic and Pediatric Sciences, Reggio Calabria University, Catanzaro, Italy.


METHODS
Forty women treated for infertility.


METHODS
The treated group received 0.5% intraperitoneal subdiaphragmatic lidocaine 40 ml and 0.5% bupivacaine 5 ml infiltration of cannula insertion sites. The control group received no treatment. In all patients the procedure was performed with atropine 0.5 mg, fentanyl 0.1 mg, droperidol 5 mg, and local anesthesia. Postoperatively, depending on the need, ketoprofene 100 mg or ketorolac 30 mg was administered intramuscularly.


RESULTS
Postoperative pain score was evaluated by visual analog scale immediately postoperatively and 1, 3, 6, 12, 24, 36, and 48 hours afterward. The treated group had significantly lower pain scores at the end of surgery and at 1-, 3-, (p <0.01), and 6-hour intervals (p <0.05). No significant differences in scores between groups were observed starting from 6 hours postoperatively.


CONCLUSIONS
Postoperative intraperitoneal lidocaine and bupivacaine infiltration of cannula sites offered a detectable benefit to women undergoing diagnostic microlaparoscopy. The effect was temporary, but induced a significant decrease in the postoperative pain for approximately 6 hours.
Zullo
F
F
Department of Gynecologic and Pediatric Sciences, Reggio Calabria University, Catanzaro, Italy.
Pellicano
M
M
Cappiello
F
F
Zupi
E
E
Marconi
D
D
Nappi
C
C
D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis*; D006801:Humans; D007274:Injections, Intraperitoneal; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008012:Lidocaine / Q000008:administration & dosage*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D011379:Prognosis; D011446:Prospective Studies; D012984:Software
D000779:Anesthetics, Local; D008012:Lidocaine; D002045:Bupivacaine