title: A prospective, randomized, double-blind, placebo-controlled trial of multimodal intraoperative analgesia for laparoscopic excision of endometriosis.
abstract: OBJECTIVE
  To assess the efficacy of multimodal intraoperative analgesia in reducing postoperative pain and/or opioid requirements in women undergoing laparoscopic excision of endometriosis.
  
  
  METHODS
  Prospective, randomized, double-blind, placebo-controlled trial.
  
  
  METHODS
  Endogynecologic department of a university teaching hospital.
  
  
  METHODS
  Women booked for laparoscopic excision of endometriosis.
  
  
  METHODS
  Intraoperative multimodal analgesia versus placebo. Analgesia consisted of Diclofenac sodium 100 mg suppository per rectum and 0.75% Ropivacaine to portal sites, subperitoneally under excision sites and topically to each subdiaphragmatic area.
  
  
  METHODS
  Postoperative total hospital opioid analgesic requirements and postoperative pain intensity.
  
  
  RESULTS
  The study was terminated prematurely, after a planned interim analysis (which included 66 randomized patients or 43% of the planned number of patients) found significantly less total hospital opioid requirements in the analgesic group compared with the placebo group (19.0 mg vs. 34.5 mg; difference -14.0 mg [95% confidence interval -26.0 to -2.0 mg]). There was no difference in postoperative pain intensity between the two groups.
  
  
  CONCLUSIONS
  The use of multimodal intraoperative analgesia at laparoscopic excision of endometriosis reduces postoperative opioid requirements.
authors.affiliation: School of Women's and Children's Health, Division of Obstetrics and Gynaecology, University of New South Wales, Royal Hospital for Women, Randwick, Sydney, New South Wales, Australia. mfcostello@unsw.edu.au
authors.forename: Michael F
authors.initials: MF
authors.lastname: Costello
authors.forename: Jason
authors.initials: J
authors.lastname: Abbott
authors.forename: Steven
authors.initials: S
authors.lastname: Katz
authors.forename: Thierry
authors.initials: T
authors.lastname: Vancaillie
authors.forename: Sally
authors.initials: S
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D000698:Analgesia / Q000379:methods; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D004008:Diclofenac / Q000008:administration & dosage*; D004311:Double-Blind Method; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D010535:Laparoscopy; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D010149:Postoperative Pain / Q000517:prevention & control; D010919:Placebos; D011446:Prospective Studies; D000077212:Ropivacaine; D055815:Young Adult
chemical_list: D000577:Amides; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D010919:Placebos; D004008:Diclofenac; D009020:Morphine; D000077212:Ropivacaine