Transcervical or intraperitoneal analgesia for laparoscopic tubal sterilization: a randomized controlled trial.
OBJECTIVE
To test the effectiveness of analgesia administered transcervically through a uterine manipulator compared with direct topical application to the fallopian tubes for relief of postoperative pain after interval laparoscopic tubal sterilization.


METHODS
Sixty-one women who had laparoscopic sterilization were enrolled in a randomized, double-masked clinical trial comparing analgesia with 75 mg of bupivacaine administered through a uterine manipulator with 75 mg of bupivacaine applied directly to the fallopian tubes through a secondary trocar. Results were evaluated using visual analog scale pain levels, time of administration of analgesics, total analgesics required, and recovery room times. We calculated that a sample size of 60 women would detect a 30% difference in pain levels with a power of 80% at a significance level of .05.


RESULTS
In the 59 women who completed the study, there were no differences in the two groups in pain levels, amounts of medications used, or times to administration of postoperative analgesia. Mean recovery room time was shorter in the group given analgesia transcervically, but that difference was not statistically significant.


CONCLUSIONS
There were no significant differences in postoperative pain relief between transcervical administration and topical application of analgesia for laparoscopic tubal sterilization.
Wrigley
L C
LC
Department of Obstetrics and Gynecology, Rochester General Hospital, Rochester, New York, USA.
Howard
F M
FM
Gabel
D
D
D000328:Adult; D000698:Analgesia / Q000379:methods*; D002045:Bupivacaine / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D005187:Fallopian Tubes / Q000187:drug effects; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D013246:Sterilization, Tubal; D014599:Uterus / Q000187:drug effects
D002045:Bupivacaine