title: Local infiltration analgesia in urogenital prolapse surgery: a prospective randomized, double-blind, placebo-controlled study.
abstract: OBJECTIVE
  To evaluate the analgesic effect of high-volume infiltration analgesia in urogenital prolapse surgery and provide a detailed description of the infiltration technique.
  
  
  METHODS
  A randomized, double-blind, placebo-controlled study following the CONSORT criteria.
  
  
  METHODS
  A university hospital.
  
  
  METHODS
  48 patients undergoing posterior wall repair and perineorraphy.
  
  
  METHODS
  Patients received high-volume (26 ml) ropivacaine 1% with epinephrine (n=23) or saline (n=22) infiltration using a systematic technique ensuring uniform delivery to all tissues incised, handled or instrumented during the procedure.
  
  
  METHODS
  Pain and opioid requirements were assessed for 24 hours as well as time spent in the post-anesthesia care unit and time to first mobilization.
  
  
  RESULTS
  Pain at rest, during coughing and movement was significantly reduced for the first four hours with the high-volume local anesthetic infiltration technique (p<0.001-0.006). Opioid requirements and time spent in the post-anesthesia care unit were significantly reduced in the ropivacaine group (p<0.001 and p<0.001, respectively) as well as the time to first mobilization (p<0.014).
  
  
  CONCLUSIONS
  Systematic high-volume infiltration analgesia is an effective analgesic technique in patients undergoing posterior wall repair and perineorraphy, and improves early recovery.
authors: Department of Anesthesiology, Hvidovre University Hospital, Kettegård Allé 30, Copenhagen, Denmark. billy.kristensen@hvh.regionh.dk
authors: Billy B
authors: BB
authors: Kristensen
authors: Yvonne H
authors: YH
authors: Rasmussen
authors: Marianne
authors: M
authors: Agerlin
authors: Monica W
authors: MW
authors: Topp
authors: Marianne O
authors: MO
authors: Weincke
authors: Henrik
authors: H
authors: Kehlet
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000008:administration & dosage*; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006785:Hospitals, University; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D056887:Pelvic Organ Prolapse / Q000175:diagnosis / Q000601:surgery*; D011446:Prospective Studies; D018570:Risk Assessment; D000077212:Ropivacaine; D012720:Severity of Illness Index; D053825:Suburethral Slings; D016896:Treatment Outcome
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine