title: Systematic review and metaanalysis of intraperitoneal instillation of local anesthetics for reduction of pain after gynecologic laparoscopy.
abstract: We reviewed the effectiveness of intraperitoneal instillation of local anesthetic on pain after gynecologic laparoscopic surgery. Sources included the Cochrane Central Register of Controlled Trials, MEDLINE/PubMed, EMBASE, and Ovid MEDLINE In-Process & Other Non-Indexed Citations databases, and abstracts, reference lists, and randomized controlled trial (RCT) registries. The 7 included RCTs compared pain scores after administration of intraperitoneal analgesics or placebo/control during gynecologic laparoscopic surgery with benign indications. Outcome measures were pain scores (per visual analog scale) at 1 to 2, 4 to 6, and 24 hours postoperatively. Pain scores were significantly lower in the groups receiving local anesthesia at 1 to 2 hours (weighted mean difference [WMD], -1.82; 95% confidence interval [CI], -2.55 to -1.08]) and 4 to 6 hours postoperatively (WMD, -2.00; 95% CI, -3.64 to -0.35), but were similar at 24 hours (WMD, -1.43; 95% CI, -1.15 to 0.96). Local analgesia instilled intraperitoneally significantly decreased pain during a 6-hour interval after gynecologic laparoscopy.
authors: Department of Obstetrics and Gynaecology, University of Western Ontario, London, Ontario, Canada. jmarks2006@meds.uwo.ca
authors: Jennifer L
authors: JL
authors: Marks
authors: Baris
authors: B
authors: Ata
authors: Togas
authors: T
authors: Tulandi
mesh_terms: D000700:Analgesics / Q000008:administration & dosage* / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000627:therapeutic use; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D007322:Instillation, Drug; D010535:Laparoscopy / Q000379:methods*; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D010529:Peritoneal Cavity; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D000779:Anesthetics, Local; D008012:Lidocaine; D002045:Bupivacaine