title: Effect of local infiltration analgesia on post-operative pain following TVT-O: a double-blind, placebo-controlled randomized study.
abstract: OBJECTIVE
  To evaluate the effect of a protocol of local anesthesia and epinephrine associated with sedo-analgesia on post-TVT-O pain in comparison with infiltration of saline and epinephrine.
  
  
  METHODS
  Forty-two patients undergoing TVT-O were randomized into two groups to receive periurethral infiltration with epinephrine only (group A, n = 21) or with epinephrine plus 1 % lidocaine hydrochloride (group B, n = 21). Post-operative pain was assessed using a visual analog scale (VAS) from 0 (absence of pain) to 10 (maximum pain possible), 1, 6, 12 and 24 h after the procedure. The total amount of analgesia was recorded and the proportion of women reporting a pain VAS score ≥4, 1 h after the procedure was calculated. ANOVA for repeated measures and Bonferroni correction, the Student's t test for independent samples, the Mann-Whitney U test, the Fisher exact test, or the χ (2) test for parametric was used.
  
  
  RESULTS
  Pain level was significantly lower in group B 1 (p = 0.01) and 6 h (p = 0.05) after surgery, but not 12 and 24 h after the procedure. No significant difference was observed in the proportion of women requesting analgesia and in the total dosage of analgesics between the two groups. A significant higher proportion of women in group A reported a pain VAS score higher than four 1 h after surgery in comparison with patients in group B.
  
  
  CONCLUSIONS
  This randomized study seems to indicate that systematic infiltration before TVT-O positioning with local anesthetic may reduce immediate post-operative pain.
authors.affiliation: Department of Neuroscience and Reproductive and Odontostomatologic Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy, gtommaselli@yahoo.it.
authors.forename: Giovanni A
authors.initials: GA
authors.lastname: Tommaselli
authors.forename: Costantino
authors.initials: C
authors.lastname: Di Carlo
authors.forename: Carmen
authors.initials: C
authors.lastname: Formisano
authors.forename: Annamaria
authors.initials: A
authors.lastname: Fabozzi
authors.forename: Carmine
authors.initials: C
authors.lastname: Nappi
mesh_terms: D000698:Analgesia / Q000379:methods*; D000700:Analgesics / Q000008:administration & dosage; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D004311:Double-Blind Method; D004333:Drug Administration Routes; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008875:Middle Aged; D059408:Pain Management; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D010919:Placebos; D053825:Suburethral Slings; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*
chemical_list: D000700:Analgesics; D000779:Anesthetics, Local; D010919:Placebos; D008012:Lidocaine; D004837:Epinephrine