title: Postoperative analgesic requirements - total laparoscopic hysterectomy versus vaginal hysterectomy.
abstract: BACKGROUND
  There is limited information available on the requirement for postoperative analgesic drugs in patients submitted to total laparoscopic hysterectomy (TLH) compared with patients undergoing vaginal hysterectomy (VH).
  
  
  OBJECTIVE
  To compare the postoperative analgesic requirements in patients who underwent a TLH with patients who had a VH.
  
  
  METHODS
  Chart review of 53 patients who had TLH and 47 who had VH and were seen postoperatively by an acute pain management service in order to assess postoperative analgesic requirements. Patient controlled analgesia (PCA) was part of the standard protocol for postoperative pain management. Analgesic requirement was recorded as the mean doses of morphine and number of days that patients used non-steroidal anti-inflammatory drugs (NSAIDs), oxycodone and tramadol.
  
  
  RESULTS
  The requirement for total morphine was approximately half the dose in patients who had a TLH (10.8 +/- 12.6 mg) compared with patients who had a VH (19.4 +/- 21.9 mg) (P 0.017). The length of use of NSAIDs was significantly reduced in patients who had undergone a TLH (2.0 +/- 0.95 days) as compared with patients who had a VH (2.85 +/- 1.1 days) (P < 0.0001).
  
  
  CONCLUSIONS
  Patients submitted to TLH require less postoperative analgesic drugs when compared with patients who had VH. Prospective randomised trials are warranted to compare analgesic requirements between patients submitted to TLH and VH.
authors.affiliation: Queensland Centre for Gynaecological Cancer, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
authors.forename: Marcelo Carraro
authors.initials: MC
authors.lastname: Nascimento
authors.forename: Andrea
authors.initials: A
authors.lastname: Kelley
authors.forename: Caroline
authors.initials: C
authors.lastname: Martitsch
authors.forename: Ines
authors.initials: I
authors.lastname: Weidner
authors.forename: Andreas
authors.initials: A
authors.lastname: Obermair
mesh_terms: D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D000700:Analgesics / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007045:Hysterectomy, Vaginal; D010535:Laparoscopy; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use*; D010098:Oxycodone / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy*; D012189:Retrospective Studies; D013997:Time Factors; D014147:Tramadol / Q000627:therapeutic use
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D014147:Tramadol; D009020:Morphine; D010098:Oxycodone