Tubal surface lidocaine mediates pre-emptive analgesia in awake laparoscopic sterilization: a prospective, randomized clinical trial.
OBJECTIVE
The purpose of this study was to determine whether lidocaine that is instilled onto the Fallopian tubes reduces pain scores in awake patients who undergo laparoscopic sterilization with Filshie clips.


METHODS
This was a prospective, randomized, placebo-controlled, double-blinded, clinical trial study that was approved by our institutional review board.


RESULTS
Pain scores (visual analogue scales) were lower in the lidocaine group (n = 12 patients) than in the placebo group (n = 12 patients) at clip application (6 vs 71 mm; P <.0001) and after 15 minutes after operation (15.5 vs 44.5 mm; P <.005). No significant differences occurred at 1-hour after operation or discharge, but more rescue analgesia was required in the placebo group ( P <.05), with more side effects ( P <.05). In a separate group of 20 women, serum lidocaine levels were measured (maximum level, 16.0 micromol/L). Holter monitoring of these patients revealed no significant arrhythmias.


CONCLUSIONS
One percent lidocaine that is instilled onto the Fallopian tubes reduces pain scores in awake patients who undergo laparoscopic sterilization with Filshie clips.
Garwood
Susan
S
Nuffield Department of Anaesthesia Oxford University, UK. susan.garwood@yale.edu
Reeder
Martin
M
Mackenzie
Ian Z
IZ
Guillebaud
John
J
D000328:Adult; D000698:Analgesia; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D004311:Double-Blind Method; D005187:Fallopian Tubes / Q000187:drug effects*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D010535:Laparoscopy; D008012:Lidocaine / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy / Q000503:physiopathology; D010149:Postoperative Pain / Q000188:drug therapy / Q000503:physiopathology; D017060:Patient Satisfaction; D011446:Prospective Studies; D020127:Recovery of Function; D013246:Sterilization, Tubal / Q000295:instrumentation / Q000379:methods; D013525:Surgical Instruments; D013997:Time Factors
D000779:Anesthetics, Local; D008012:Lidocaine