Prior analgesic dosage during gynecologic laparoscopy: A randomized trial

Abstract

To evaluate the efficacy of intraoperative infusion of Levobupivacaine solution for the relief of pain after operative gynecologic laparoscopy. Design: Double-blind, randomized, controlled trial. Materials & method: Ninety females aged 18 to 60 years who underwent gynecologic laparoscopic surgery from October 2018 through October 2019. The patients were divided into three groups, Group A (n =30): Intraperitoneal infusion of a mixture of 10 ml of 0.5% Levobupivacaine (50 mg) with epinephrine (1:500) in 40 ml of Ringer's lactate solution postoperatively. Group B (n = 30): the same mixture solution infusion preoperatively and postoperatively (total 100 mg Levobupivacaine). Group C (n = 30): Control. Statistical analysis and results: Shoulder tip pain (STP), abdominal parietal pain (APP), and abdominal visceral pain (AVP) were recorded on a visual analog scale at 2, 4, 8, 16, and 24 hours postoperatively. A total of 79 patients fulfilled the study criteria. The overall incidence of STP was 61.5%. Abdominal visceral pain in group B was significantly less than in group C at 2 and 4 hours postoperatively (p =.011 and p = .010, respectively). Conclusion: Intraperitoneal Levobupivacaine administration both immediately after placement of trocars and at the end of surgery was found to be effective in reducing the intensity of AVP but not in reducing STP, APP, or postoperative analgesia consumption after gynecologic laparoscopic procedures.