Preoperative transcervical analgesia for laparoscopic sterilization with Filshie clips.A double blind randomized trial

Abstract

Objective. To evaluate the use of preoperative transcervical analgesia for reducing postoperative pain from laparoscopic sterilization with Filshie clips. Design. A double blind, randomized, placebo-controlled trial. Setting. Gynecologic day-care clinic of Vejle Hospital, Vejle, Denmark. Sample. Seventy-eight healthy women were attending the public hospital requesting sterilization. Methods. Participants received bupivacaine 0.25% 20 mL or placebo normal saline 20 mL injected into the uterus, though the fallopian tubes and into the pelvis before tubal occlusion with Filshie clips. Main outcome measures. Post-operative visual analog pain score and request for analgesia were recorded. Results. At 30 min after clip application there was a non-significant reduction in pain-score on VAS. However, at 1, 2, 3 and 4 h median pain score on VAS was similar in both groups. Patients request for postoperative analgesia was similar in the two groups. Conclusions. Preoperative transcervical perfusion of the uterus, fallopian tubes and into the pelvis did not reduce postoperative pain or request for analgesics after laparoscopic sterilization with Filshie clips.

Anesthesia for outpatient gynecologic surgery

“…This technique has been studied occasionally since then, including one report in 2000 [10] and another in 2003 [11]. Wrigley et al [10] compared transcervical administration with topical application and found no difference in pain scores.…”

“…Wrigley et al [10] compared transcervical administration with topical application and found no difference in pain scores. Schytte et al [11] studied women receiving Filshie clips, with one group receiving transcervical local anesthetic and the other placebo. They could not demonstrate a reduction in postoperative pain.…”

Reducing Postoperative Pain After Tubal Ligation With Rings or Clips

“…Seven studies 18,[20][21][22][23][24]26 reported results only as medians, and 13 [8][9][10][11][12][13][14][15][16][17]19,25,27 reported results as means. For the purposes of the meta-analysis, we included all studies (means and medians), but we also examined them separately.…”

“…Seventeen studies [8][9][10][11][13][14][15][16][17][18][19][20][21][22][24][25][26] reported results using visual analog scale (VAS), whereas three studies 12,23,27 used McGill. In brief, VAS quantifies pain intensity using a 10-cm line with ends anchored at 0 cm (no pain) and 10 cm (maximal pain).…”

“…We subsequently excluded one paper as a result of our inability to calculate a variance estimate, 7 leaving 20 papers for the analysis (Table 1). [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Only one author 10 provided useful additional information (regarding the timing of pain measurements).…”