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

• Lee JH
• Cho SH
• Eoh KJ
• Lee JY
• Nam EJ
• Kim S
• Kim SW
• Kim YT

• KMID: 2500427
• DOI: http://doi.org/10.5468/ogs.2020.63.3.363

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

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

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  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.

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