Lignocaine gel in minimally invasive surgery - A pilot cohort study.
BACKGROUND
The administration of local anaesthetic at the conclusion of minimally invasive procedures has been shown to reduce postoperative pain. However, it is often not feasible to reach target surgical sites using a needle, making it difficult to administer injectable local anaesthetic. Formulations currently available for topical use are also not sterile, adhere poorly, and are not adjusted to neutral pH at the time of use. To address these limitations, a new sterile, aqueous 4.8% lignocaine gel was formulated for topical application on surgical wounds.


OBJECTIVE
To determine the clinical feasibility, safety and tolerability of the topical lignocaine gel.


METHODS
A total of 125 female patients underwent minimally invasive gynaecological procedures. The lignocaine gel was applied to any intra-abdominal, intra-uterine or intra-vaginal surgical wounds. The incidence of any intra- or postoperative complications was determined via retrospective review of surgical reports, hospital files and outpatient clinic files.


RESULTS
In all cases, the surgeon was able to apply the gel successfully to the desired site. There were no intra-operative complications. There were no adverse events encountered during recovery or hospitalisation which are likely to be associated with the lignocaine gel. Eight patients experienced adverse events during the postoperative period which could be linked to the use of the gel. However, the incidence of these was within the known range of adverse events for these procedures.


CONCLUSIONS
A sterile lignocaine gel can be safely used in minimally invasive surgery.
Beg
Natasha
N
Department of Endo-gynaecology, Women's Health & Research Institute of Australia, Australia. natasha.beg@student.unsw.edu.au
Vancaillie
Thierry
T
Hewitt
Alan
A
Eggermont
Julie
J
Armstrong
Georgina
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D005782:Gels / Q000627:therapeutic use; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control*; D010865:Pilot Projects; D055815:Young Adult
D000779:Anesthetics, Local; D005782:Gels; D008012:Lidocaine