Bupivacaine plus epinephrine for laparoscopic myomectomy: a randomized placebo-controlled trial.
OBJECTIVE
To evaluate the effectiveness of the injection of bupivacaine plus epinephrine before laparoscopic myomectomy.


METHODS
Sixty premenopausal women with uterine leiomyomata were enrolled in a randomized controlled design and intraoperatively treated with injection of bupivacaine plus epinephrine (group A) or saline solution (group B) during laparoscopic myomectomy. Uterine size and volume, number of leiomyomata, hematological parameters, total operative time, enucleation time of each myoma, suturing time of the myomectomy, blood loss, degree of surgical difficulty, and postoperative pain were evaluated. Just before and after the injection of vasoconstrictive or saline solution, systolic and diastolic blood pressure and heart rate were recorded in each subject.


RESULTS
Blood loss, total operative and enucleation time, and degree of surgical difficulty was significantly (P <.05) lower in group A than in group B. No difference was observed between groups in suturing time of the myomectomy. The number of vials of pain medication used postoperatively was significantly (P <.05) lower in group A than in group B. No differences in systolic and diastolic blood pressure or heart rate was recorded between the 2 groups.


CONCLUSIONS
The injection of bupivacaine plus epinephrine during laparoscopic myomectomy is effective in reducing blood loss, total operative and enucleation time, degree of surgical difficulty, and postoperative pain.
Department of Obstetrics and Gynecology, University Magna Graecia of Catanzaro, Catanzaro, Italy.
Fulvio
F
Zullo
Stefano
S
Palomba
Domenico
D
Corea
Massimiliano
M
Pellicano
Tiziana
T
Russo
Angela
A
Falbo
Ermanno
E
Barletta
Pasquale
P
Saraco
Patrizia
P
Doldo
Errico
E
Zupi
D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004837:Epinephrine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007267:Injections; D007432:Intraoperative Period; D010535:Laparoscopy / Q000379:methods; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D011446:Prospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery*; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000627:therapeutic use*
D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D002045:Bupivacaine; D004837:Epinephrine