Obstet Gynecol Sci.  2020 Apr;63(3):363-369. 10.5468/ogs.2020.63.3.363.

Effect of bupivacaine versus lidocaine local anesthesia on postoperative pain reduction in single-port access laparoscopic adnexal surgery using propensity score matching

Affiliations
  • 1Department of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, Korea

Abstract


Objective
The umbilicus is a single, painful incisional site on the abdomen during trans-umbilical single-port access laparoscopic surgery. Previously, we found that periumbilical lidocaine could reduce postoperative pain. This study aimed to compare the efficacy of bupivacaine and lidocaine in reducing pain.
Methods
We performed a retrospective analysis in a study group (Bupivacaine group, 100 patients who received periumbilical infiltration of bupivacaine before their incisional site repair completion) and control group (Lidocaine group, 100 patients who received lidocaine at their incisional site repair completion). We compared postoperative pain based on the numerical rating scale (NRS) between propensity score-matched Bupivacaine-treated (n=50) and Lidocaine-treated (n=50) patients.
Results
The postoperative pain scores based on the NRS were not significantly different between the 2 groups until 12 hours post-operation. However, 24 hours post-operation, the Bupivacaine group showed significantly lower pain than the Lidocaine group (24 hours, 1.76±1.07 vs. 2.53±1.11 NRS, P<0.001; 48 hours, 0.84±0.85 vs. 2.16±0.85 NRS, P<0.001).
Conclusion
Periumbilical infiltration of bupivacaine has a longer acting efficacy on reducing postoperative surgical pain than that of lidocaine.

Keyword

Adnexal disease; Gynecology; Bupivacaine; Lidocaine; Postoperative pain

Figure

  • Fig. 1 Umbilical infiltration of local anesthesia while single-port access (SPA) laparoscopic surgery. (A) SPA laparoscopic surgery, (B) umbilical infiltration of local anesthesia.

  • Fig. 2 Mean postoperative pain in numerical rating scale (NRS)±standard deviation is graphed as a function of time for matched patients in the Bupivacaine (n=50) and Lidocaine (n=50) group.a)P<0.001, Student's t-test.


Reference

1. Nieboer TE, Johnson N, Lethaby A, Tavender E, Curr E, Garry R, et al. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev. 2009; CD003677. PMID: 19588344.
Article
2. Thompson B, Wheeless RC. Outpatient sterilization by laparoscopy. A report of 666 patients. Obstet Gynecol. 1971; 38:912–915. PMID: 4256611.
3. Pelosi MA, Pelosi MA 3rd. Laparoscopic hysterectomy with bilateral salpingo-oophorectomy using a single umbilical puncture. N J Med. 1991; 88:721–726. PMID: 1836254.
4. Song T, Kim ML, Jung YW, Yoon BS, Joo WD, Seong SJ. Laparoendoscopic single-site versus conventional laparoscopic gynecologic surgery: a metaanalysis of randomized controlled trials. Am J Obstet Gynecol. 2013; 209:317.e1–317.e9. PMID: 23860211.
5. Lee IO, Yoon JW, Chung D, Yim GW, Nam EJ, Kim S, et al. A comparison of clinical and surgical outcomes between laparo-endoscopic single-site surgery and traditional multiport laparoscopic surgery for adnexal tumors. Obstet Gynecol Sci. 2014; 57:386–392. PMID: 25264529.
Article
6. Lo CW, Yang SS, Tsai YC, Hsieh CH, Chang SJ. Comparison of laparoendoscopic single-site versus conventional multiple-port laparoscopic herniorrhaphy: a systemic review and meta-analysis. Hernia. 2016; 20:21–32. PMID: 26645961.
Article
7. Kim SK, Lee JH, Lee JR, Suh CS, Kim SH. Laparoendoscopic single-site myomectomy versus conventional laparoscopic myomectomy: a comparison of surgical outcomes. J Minim Invasive Gynecol. 2014; 21:775–781. PMID: 24632396.
Article
8. Markar SR, Karthikesalingam A, Thrumurthy S, Muirhead L, Kinross J, Paraskeva P. Single-incision laparoscopic surgery (SILS) vs. conventional multiport cholecystectomy: systematic review and meta-analysis. Surg Endosc. 2012; 26:1205–1213. PMID: 22173546.
Article
9. Yang L, Gao J, Zeng L, Weng Z, Luo S. Systematic review and meta-analysis of single-port versus conventional laparoscopic hysterectomy. Int J Gynaecol Obstet. 2016; 133:9–16. PMID: 26797206.
Article
10. Yim GW, Lee M, Nam EJ, Kim S, Kim YT, Kim SW. Is single-port access laparoscopy less painful than conventional laparoscopy for adnexal surgery? A comparison of postoperative pain and surgical outcomes. Surg Innov. 2013; 20:46–54. PMID: 22410390.
Article
11. Eoh KJ, Lee JY, Nam EJ, Kim S, Kim YT, Kim SW. Periumbilical infiltration of lidocaine with epinephrine for postoperative pain reduction in single-port laparoscopic adnexal surgery. J Obstet Gynaecol. 2018; 38:1135–1139. PMID: 30207501.
Article
12. Spivey WH, McNamara RM, MacKenzie RS, Bhat S, Burdick WP. A clinical comparison of lidocaine and bupivacaine. Ann Emerg Med. 1987; 16:752–757. PMID: 3296876.
Article
13. Kim J, Yim E, Bae H. Performance of DRG-based reimbursement policy in national health insurance: eight years' experiences. Value Health. 2015; 18:A546.
14. Park JY, Kim DY, Suh DS, Kim JH, Nam JH. Laparoendoscopic single-site versus conventional laparoscopic surgery for ovarian mature cystic teratoma. Obstet Gynecol Sci. 2015; 58:294–301. PMID: 26217600.
Article
15. Kahokehr A, Sammour T, Srinivasa S, Hill AG. Systematic review and meta-analysis of intraperitoneal local anaesthetic for pain reduction after laparoscopic gastric procedures. Br J Surg. 2011; 98:29–36. PMID: 20979101.
Article
16. Woolf CJ, Chong MS. Preemptive analgesia--treating postoperative pain by preventing the establishment of central sensitization. Anesth Analg. 1993; 77:362–379. PMID: 8346839.
Article
17. Alhelail M, Al-Salamah M, Al-Mulhim M, Al-Hamid S. Comparison of bupivacaine and lidocaine with epinephrine for digital nerve blocks. Emerg Med J. 2009; 26:347–350. PMID: 19386869.
Article
18. Miller RD, Ward TA, McCulloch CE, Cohen NH. A comparison of lidocaine and bupivacaine digital nerve blocks on noninvasive continuous hemoglobin monitoring in a randomized trial in volunteers. Anesth Analg. 2014; 118:766–771. PMID: 24651230.
Article
19. Su N, Wang H, Zhang S, Liao S, Yang S, Huang Y. Efficacy and safety of bupivacaine versus lidocaine in dental treatments: a meta-analysis of randomised controlled trials. Int Dent J. 2014; 64:34–45. PMID: 24117122.
Article
20. Yu X, Wang J, Huang L, Yu X, He Z. Efficacy and safety of bupivacaine versus lidocaine in local anesthesia of the nasopharynx: a meta-analysis. Am J Rhinol Allergy. 2016; 30:176–180. PMID: 27368150.
Article
21. Fathy W, Hussein M, Khalil H. Effect of local anesthesia (with lidocaine vs bupivacaine) on cognitive function in patients undergoing elective cataract surgery. Local Reg Anesth. 2019; 12:1–6. PMID: 30643450.
Article
22. Bernards CM, Kopacz DJ. Effect of epinephrine on lidocaine clearance in vivo: a microdialysis study in humans. Anesthesiology. 1999; 91:962–968. PMID: 10519498.
Full Text Links
  • OGS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr