Reducing Postoperative Pain After Tubal Ligation With Rings or Clips

Harrison, Margo S.; DiNapoli, Marianne; Westhoff, Carolyn

doi:10.1097/aog.0000000000000342

Cited by 8 publications

(5 citation statements)

References 39 publications

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“…Evidence relating to postoperative pain was limited in our review; however, for the comparison of partial salpingectomy versus electrocoagulation, and tubal rings versus electrocoagulation, moderate-quality evidence indicated that there was less postoperative pain with electrocoagulation. A recent review of RCTs of local anaesthesia to reduce postoperative pain following interval laparoscopic sterilisation found that the intraoperative application of local anaesthetic to the tubes significantly reduced postoperative pain for ring and clip sterilisation (Harrison 2014). In addition, a protocol for a Cochrane Review to evaluate the e ectiveness of interventions for pain relief in women undergoing postpartum mini-laparotomy tubal sterilisation has recently been published (Lumbiganon 2015).…”

Section: Agreements and Disagreements With Other Studies Or Reviewsmentioning

confidence: 99%

Techniques for the interruption of tubal patency for female sterilisation

Lawrie

Kulier

Nardin

2016

Cochrane Database of Systematic Reviews

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Low risk population Complaints: Postoperative pain (24 hours) 477 per 1000 544 per 1000 (420 to 706) OR 1.14 (0.88 to 1.48) 922 (3) ⊕⊕⊕⊕ high *The basis for the assumed risk is the median control group (clip) risk across studies. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; OR: odds ratio GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.

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Section: Agreements and Disagreements With Other Studies Or Reviewsmentioning

confidence: 99%

Techniques for the interruption of tubal patency for female sterilisation

Lawrie

Kulier

Nardin

2016

Cochrane Database of Systematic Reviews

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“…Pain from tubal sterilization is believed to be derived from the prostaglandins released from the traumatized fallopian tubes (23). As well, pain arises from ischemia or necrosis of the ligation site of the tubes (24). These reasons explain why the tubal sterilization had a high likelihood of generating postoperative pain.…”

Section: Resultsmentioning

confidence: 99%

Gestational diabetes and intraoperative tubal sterilization are risk factors for high incidence of pain after cesarean delivery: a prospective observational study

Nivatpumin¹,

Pangthipampai²,

Dejarkom³

et al. 2022

Ann Palliat Med

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Background: Postcesarean delivery pain leads to several adverse maternal outcomes. The primary objective of this study was to determine the incidence of moderate-to-severe pain after the use of spinal morphine for cesarean delivery. The secondary aim was to identify factors influencing moderate-to-severe pain.Methods: This was a prospective observational study. The inclusion criteria were a patient age of ≥18 years, and undergoing elective cesarean delivery under spinal anesthesia with intrathecal morphine (200 mcg). Moderate-to-severe pain was defined as a numerical rating scale score of more than 3.Preoperative and intraoperative data were collected including parity, history of cesarean delivery, pregnancyassociated problem, anesthesia blockade level, level of surgeon experience, incision type, tubal sterilization or appendectomy, and peritoneum suture. Chi-squared or Fisher's exact tests were used to examine risk factors. Multiple logistic regression was used to analyze independent factors associated with moderate to severe pain. Results: In all, 660 patients were enrolled. As 16 were subsequently removed because they met the study withdrawal criteria, data relating to 644 patients were analyzed. The incidence of moderate-tosevere pain during the first postoperative day was 451/644 patients [70.03%; 95% confidence interval (CI): 66.38-73.44%]. The median pain score [interquartile range (IQR)] was 5 (3-6), with 176/644 (27.33%) patients needing rescue analgesics. A multivariate analysis revealed that two factors were associated with moderate-to-severe pain on the first postoperative day: gestational diabetes [adjusted OR (AOR), 1.849; 95% CI: 1.068-3.203; P=0.028] and intraoperative tubal sterilization (AOR, 1.533; 95% CI: 1.060-2.218; P=0.023). A significantly higher number of patients experienced moderate-to-severe pain on postoperative Day 1 [451/644 (70.03%)] than on Day 2 [349/644 (54.19%); P<0.001]. The median pain score [IQR] on postoperative Day 2 was 4 [3-5], which was less than on Day 1 (P<0.001).Conclusions: A high incidence of moderate-to-severe postoperative pain was found after a single dose of spinal morphine for cesarean delivery. Adequate pain control is required in women at risk of postcesarean delivery pain. More studies are needed on the analgesic requirements of diabetic patients or patients who receive intraoperative tubal sterilization.

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“…Pain from tubal sterilization is believed to be derived from the prostaglandins released from the traumatized fallopian tubes [22]. As well, pain arises from ischemia or necrosis of the ligation site of the tubes [23]. These reasons explain why the tubal sterilization had a high likelihood of generating postoperative pain.…”

Section: Discussionmentioning

confidence: 99%

Gestational Diabetes and Intraoperative Tubal Sterilization are Risk Factors for Pain After Cesarean Delivery: A Prospective Observational Study.

Nivatpumin¹,

Pangthipampai²,

Dejarkom³

et al. 2020

Preprint

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Background: Postcesarean delivery pain leads to several adverse maternal outcomes. The primary objective of this study was to determine the incidence of moderate-to-severe pain after the use of spinal morphine for cesarean delivery. The secondary aim was to identify the factors influencing the moderate-to-severe pain.Methods: This prospective observational study was conducted at a single university hospital. The inclusion criteria were a patient age of ≥ 18 years, and undergoing elective cesarean delivery under spinal anesthesia with intrathecal morphine (200 mcg). Moderate-to-severe pain was defined as a numerical-rating-scale score of more than 3 within 24 hours postoperatively. Patients’ demographic characteristics, preoperative obstetric data, and intraoperative and postoperative data were collected and analyzed.Results: In all, 660 patients were enrolled. As 16 were subsequently removed because they met the study withdrawal criteria, data relating to 644 patients were analyzed. The incidence of moderate-to-severe pain during the first postoperative day was 451/644 patients (70.03%; 95% confidence interval [CI], 66.38%–73.44%). The median pain score (interquartile range [IQR]) was 5 (3–6), with 176/644 (27.33%) of patients requiring a rescue analgesic. A multivariate analysis revealed that two factors were associated with moderate-to-severe pain on the first postoperative day: gestational diabetes (adjusted OR [AOR], 1.849; 95% CI, 1.068–3.203; p-value = 0.028), and intraoperative tubal sterilization (AOR, 1.533; 95% CI, 1.060–2.218; p = 0.023). A significantly higher number of patients experienced moderate-to-severe pain on postoperative Day 1 (451/644 [70.03%]) than Day 2 (348/644 [54.19%]; p < 0.001). The median pain score (IQR) on postoperative Day 2 was 4 (3–5), which was less than that for Day 1 (p < 0.001).Conclusions: A high incidence of moderate-to-severe postoperative pain was found after a single dose of spinal morphine for cesarean delivery. Gestational diabetes and intraoperative tubal sterilization were the independent factors correlated with the pain.Trial registration: Clinicaltrial.gov registration number NCT03205813

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Reducing Postoperative Pain After Tubal Ligation With Rings or Clips

Abstract: Use of local anesthetic during laparoscopic tubal ligation substantially reduces postoperative pain up to 8 hours after surgery.

Cited by 8 publications

References 39 publications

Techniques for the interruption of tubal patency for female sterilisation

Techniques for the interruption of tubal patency for female sterilisation

Gestational diabetes and intraoperative tubal sterilization are risk factors for high incidence of pain after cesarean delivery: a prospective observational study

Gestational Diabetes and Intraoperative Tubal Sterilization are Risk Factors for Pain After Cesarean Delivery: A Prospective Observational Study.

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