Does bupivacaine in laparoscopic ports reduce postsurgery pain in tubal ligation by electrocoagulation? A randomized controlled trial.
BACKGROUND
Tubal ligation (TL) is the most popular method of permanent contraception. In order to reduce postoperative pain, different analgesic techniques have been proposed. The objective of this study was to compare the level of postoperative pain in patients submitted to TL with electrocoagulation, under general anesthesia, using bupivacaine infiltration vs. placebo in trocar ports.


METHODS
Consecutive patients scheduled for laparoscopic TL were randomized by sequenced coded envelopes to receive bupivacaine 0.5% (n=29) or placebo (n=24). Pain was blindly assessed at 15 min, 30 min, 120 min and 14 h postoperatively, by verbal analogue scale (VAS). Standard pain medications (morphine, dipyrone and sodium diclofenac) were prescribed for the subjects and compared between groups.


RESULTS
No difference in pain assessment was found between bupivacaine and placebo groups at all times [median (25-75 quartiles)] (all p>.05): 15 min: 3 (1-6.3) vs. 4 (0-7); 30 min: 1.5 (0-4.3) vs. 2 (0-5); 2 h: 0 (0-0.5) vs. 0 (0-1); 14 h: 1 (0-4) vs. 0 (0-4); and for use of analgesics: dipyrone (g): 1 (0-1) vs. 1 (0-1); morphine (mg): 3 (0-3) vs. 3 (0-3.5); sodium diclofenac (mg): 0 (0-50) vs. 0 (0-50).


CONCLUSIONS
The use of local injection of bupivacaine 0.5% in the trocar ports was not superior to placebo to reduce pain after laparoscopic TL with electrocoagulation under general anesthesia.
Savaris
Ricardo F
RF
Departamento e Serviço de Ginecologia e Obstetrícia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. rsavaris@hcpa.ufrgs.br
Chicar
Lydia L
LL
Cristovam
Rafael S
RS
Moraes
Gisele S
GS
Miguel
Oscar A
OA
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000772:Anesthesia, Local / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004564:Electrocoagulation; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D020706:Laparoscopes / Q000009:adverse effects; D010535:Laparoscopy / Q000009:adverse effects*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D013246:Sterilization, Tubal / Q000379:methods*; D013997:Time Factors
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D002045:Bupivacaine