Efficacy of continuous wound infiltration of local anesthetic for pain relief after gynecologic laparoscopy.
OBJECTIVE
To assess the efficacy of analgesia provided by continuous ropivacaine wound infiltration after gynecologic laparoscopy.


METHODS
Sixty patients who underwent gynecologic laparoscopy at Ajou University School of Medicine, Suwon, Republic of Korea, between March and May 2012 were randomized to receive either intravenous fentanyl and ketorolac infusion on demand by patient-controlled analgesia (IV PCA group, n=31) or continuous wound infiltration of local ropivacaine (CWI group, n=29). Postoperative pain and postoperative nausea and vomiting (PONV) were assessed via a visual analog scale. The number of patients who requested rescue analgesia was recorded.


RESULTS
There was no significant difference in postoperative pain between the 2 groups, but more patients requested rescue analgesia in the CWI group than in the IV PCA group in 24 hours (18 versus 9 patients, respectively; P=0.010). The PONV scores at 12 and 24 hours were, respectively, 0.28 and 0.27 in the CWI group, and 0.71 and 0.73 in the IV PCA group (P=0.004). Nine patients requested cessation of IV PCA because of severe nausea or vomiting.


CONCLUSIONS
Continuous ropivacaine wound infiltration was found to be as effective as patient-controlled analgesia for postoperative pain relief after gynecologic laparoscopy. This technique provides good analgesia with less opioid analgesic requirement and few adverse effects.
Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Republic of Korea.
Tae-Wook
TW
Kong
Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Republic of Korea.
Hyogyeong
H
Park
Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Republic of Korea.
Ji-Yoon
JY
Cheong
Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Republic of Korea.
Sang-Ki
SK
Min
Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Republic of Korea. Electronic address: hsryu@ajou.ac.kr.
Hee-Sug
HS
Ryu
D000328:Adult; D000577:Amides / Q000008:administration & dosage* / Q000009:adverse effects; D016058:Analgesia, Patient-Controlled / Q000009:adverse effects / Q000379:methods; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000009:adverse effects; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D006801:Humans; D036502:Infusions, Intralesional; D020910:Ketorolac / Q000008:administration & dosage / Q000009:adverse effects; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology; D011446:Prospective Studies; D056910:Republic of Korea; D000077212:Ropivacaine; D016896:Treatment Outcome
D000577:Amides; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000077212:Ropivacaine; D005283:Fentanyl; D020910:Ketorolac
Continuous ropivacaine wound infiltration; Gynecologic laparoscopy; Postoperative pain