title: Effect of Intraperitoneal Bupivacaine on Postoperative Pain in the Gynecologic Oncology Patient.
abstract: OBJECTIVE
  To evaluate if the administration of intraperitoneal bupivacaine decreased postoperative pain in patients undergoing minimally invasive gynecologic and gynecologic cancer surgery.
  
  
  METHODS
  Retrospective cohort study (Canadian Task Force classification II-3).
  
  
  METHODS
  University-based gynecologic oncology practice operating at a tertiary medical center.
  
  
  METHODS
  All patients on the gynecologic oncology service undergoing minimally invasive surgery between September 2011 and June 2013.
  
  
  METHODS
  Starting August 2012, intraperitoneal administration of .25% bupivacaine was added to all minimally invasive surgeries. These patients were compared with historical control subjects who had surgery between September 2011 and July 2012 but did not receive intraperitoneal bupivacaine.
  
  
  RESULTS
  One-hundred thirty patients were included in the study. The patients who received intraperitoneal bupivacaine had lower median narcotic use on the day of surgery and the first postoperative day compared with those who did not receive intraperitoneal bupivacaine (day 0: 7.0 mg morphine equivalents vs 11.0 mg, p = .007; day 1: .3 mg vs 1.7 mg, p = .0002). The median patient-reported pain scores were lower on the day of surgery in the intraperitoneal bupivacaine group (2.7 vs 3.2, p = .05) CONCLUSIONS: The administration of intraperitoneal bupivacaine was associated with improved postoperative pain control in patients undergoing minimally invasive gynecologic and gynecologic cancer surgery and should be further evaluated in a prospective study.
authors.affiliation: Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Colleen
authors.initials: C
authors.lastname: Rivard
authors.affiliation: Biostatistics and Bioinformatics, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Rachel Isaksson
authors.initials: RI
authors.lastname: Vogel
authors.affiliation: Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota. Electronic address: dkteoh@umn.edu.
authors.forename: Deanna
authors.initials: D
authors.lastname: Teoh
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications / Q000601:surgery*; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006801:Humans; D007274:Injections, Intraperitoneal; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000150:complications / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000517:prevention & control; D017060:Patient Satisfaction; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D002045:Bupivacaine
keywords: Bupivacaine; Hysterectomy; Laparoscopy; Local anesthesia; Minimally invasive surgery