Obstet Gynecol Sci.  2017 Sep;60(5):455-461. 10.5468/ogs.2017.60.5.455.

Port site infiltration of local anesthetic after laparoendoscopic single site surgery for benign adnexal disease

• Kim JE
• Shim SH
• Dong M
• Lee H
• Hwang HS
• Kwon HS
• Lee SJ
• Lee JY
• Sohn IS
• Kim SN
• Kang SB

• KMID: 2393845
• DOI: http://doi.org/10.5468/ogs.2017.60.5.455

Abstract

OBJECTIVE
To determine whether local bupivacaine injection into the incision site after gynecologic laparoendoscopic single site surgery (LESS) improves postoperative pain.
METHODS
This prospective cohort study included consecutive 158 patients who had LESS for benign adnexal disease from March 2013 to December 2015. Chronologically, 82 patients (March 2013 to August 2014) received no bupivacaine (group 1) and 76 (August 2014 to December 2015) received a bupivacaine block (group 2). For group 2, 10 mL 0.25% bupivacaine was injected into the 20 mm-incision site through all preperitoneal layers after LESS completion. Primary outcome is postoperative pain score using the visual analog scale (VAS).
RESULTS
There was no difference in clinicopathological characteristics between the groups. Operating time (expressed as median [range], 92 [55-222] vs. 100 [50-185] minutes, P=0.137) and estimated blood loss (50 [30-1,500] vs. 125 [30-1,000] mL, P=0.482) were similar between the groups. Post-surgical VAS pain scores after 3 hours (3.5 [2-6] vs. 3.5 [2-5], P=0.478), 6 to 8 hours (3.5 [2-6] vs. 3 [1-8], P=0.478), and 16 to 24 hours (3 [2-4] vs. 3 [1-7], P=0.664) did not differ between groups.
CONCLUSION
Bupivacaine injection into the trocar site did not improve postoperative pain after LESS. Randomized trials are needed to evaluate the benefits of local bupivacaine anesthetic for postoperative pain reduction.

Keyword

Local anesthesia; Laparoscopy; Pain; Minimally invasive surgical procedures

MeSH Terms

Adnexal Diseases*
Anesthesia, Local
Bupivacaine
Cohort Studies
Female
Humans
Laparoscopy
Minimally Invasive Surgical Procedures
Pain, Postoperative
Prospective Studies
Surgical Instruments
Visual Analog Scale
Bupivacaine

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