title: Effects of local bupivacaine instillation on pain after laparoscopy.
abstract: OBJECTIVE
  To evaluate the effect of preincisional and intraperitoneal bupivacaine administration on immediate and late pain after operative laparoscopy.
  
  
  METHODS
  Randomized study (Canadian Task Force classification I).
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  One hundred fifty women undergoing laparoscopy for various gynecologic indications.
  
  
  METHODS
  A dose of 0.5% bupivacaine 10 ml (50 mg) was injected into cannula sites before incisions and another 10 ml diluted with 100 ml saline into the peritoneal cavity at completion of the procedure. Equal amount of physiologic saline was used in controls.
  
  
  RESULTS
  Modified McGill pain intensity scores and amount of analgesic required in the recovery room and within 24 hours postoperatively were evaluated. Of 150 women, 142 completed the study (71 bupivacaine group, 71 controls). Groups did not differ significantly in body mass index, duration of surgery, return to consciousness, and analgesic requirement during 3-hour observation in the recovery room and 24 hours after discharge. Pain scores were highest 30 minutes after the procedure in both groups. At that time the pain score in the bupivacaine group was lower than that in the control group (1.8 +/- 0.2 vs 2.3 +/- 0.2, p <0.05). Beyond that time, the groups did not differ in pain scores and analgesic requirements.
  
  
  CONCLUSIONS
  Postoperative pain is the highest within 30 minutes after laparoscopy. Local instillation of bupivacaine before incision and intraperitoneally was effective in reducing pain immediately after operative laparoscopy, but the effect was not seen beyond 30 minutes.
authors.affiliation: Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec H3A 1A1, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Saleh
authors.forename: G
authors.initials: G
authors.lastname: Fox
authors.forename: A
authors.initials: A
authors.lastname: Felemban
authors.forename: C
authors.initials: C
authors.lastname: Guerra
authors.forename: T
authors.initials: T
authors.lastname: Tulandi
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D006801:Humans; D010535:Laparoscopy; D010149:Postoperative Pain / Q000517:prevention & control*; D013997:Time Factors
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine