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Impact of bupivacaine injection to trocar sites on postoperative pain following laparoscopic hysterectomy: Results from a prospective, multicentre, double-blind randomized controlled trial.
Eur J Obstet Gynecol Reprod Biol. 2020 Jul 07; 252:317-322.EJ

Abstract

OBJECTIVES

Laparoscopic surgery has numerous advantages over open surgery in view of postoperative pain. In this context, to elevate its benefits and patient satisfaction, different pain management interventions have been used so far. This study aimed to evaluate the effect of bupivacaine injection to trocar sites following laparoscopic hysterectomy for the management of postoperative pain.

STUDY DESIGN

In this study, patients were randomized into two groups (56 cases; 52 controls). A single injection of bupivacaine (0.5 %, 5 mg/mL) was introduced to trocar sites under subcutaneous tissue at a dose of 4 ml for the umbilicus and 2 ml for each 5-mm ancillary trocar site in the study group. No bupivacaine was administered to the control group. The primary aim was to measure differences in 2 -h postoperative numerical rating scale (NRS) pain scores between the two groups. The secondary aims were to evaluate differences between 1-, 4-, 6-, 24- and 48 -h postoperative NRS pain scores, surgical complications, estimated blood loss, duration of operation and analgesic consumption.

RESULTS

The number of postoperative rescue doses of analgesics was found to be lower in the study group compared to the control group (median of 2 vs. 4; p < 0.01). The 1-, 4-, 6-, 24- and 48-hour postoperative NRS pain scores were also found to be lower in the study group compared to the control group (p < 0.01 at each follow-up). The mean duration of surgery and uterus removal, as well as the estimated blood loss, were not significantly different between the two groups.

CONCLUSIONS

The present study suggests that bupivacaine injection to trocar sites is an effective and safe method for reducing pain following laparoscopic hysterectomy.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, Ege University School of Medicine, Izmir, Turkey; Department of Stem Cell, Ege University Institute of Health Sciences, Izmir, Turkey. Electronic address: ismethortu@yahoo.com.Department of Obstetrics and Gynaecology, University of Health Sciences Derince Education and Research Hospital, Kocaeli, Turkey.Department of Obstetrics and Gynaecology, University of Health Sciences Derince Education and Research Hospital, Kocaeli, Turkey.Department of Obstetrics and Gynaecology, University of Health Sciences Derince Education and Research Hospital, Kocaeli, Turkey.Department of Anaesthesiology, University of Health Sciences Derince Education and Research Hospital, Kocaeli, Turkey.Department of Anaesthesiology, University of Health Sciences Derince Education and Research Hospital, Kocaeli, Turkey.Department of Obstetrics and Gynaecology, University of Health Sciences Derince Education and Research Hospital, Kocaeli, Turkey.Department of Obstetrics and Gynaecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32653604

Citation

Hortu, Ismet, et al. "Impact of Bupivacaine Injection to Trocar Sites On Postoperative Pain Following Laparoscopic Hysterectomy: Results From a Prospective, Multicentre, Double-blind Randomized Controlled Trial." European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 252, 2020, pp. 317-322.
Hortu I, Turkay U, Terzi H, et al. Impact of bupivacaine injection to trocar sites on postoperative pain following laparoscopic hysterectomy: Results from a prospective, multicentre, double-blind randomized controlled trial. Eur J Obstet Gynecol Reprod Biol. 2020;252:317-322.
Hortu, I., Turkay, U., Terzi, H., Kale, A., Yılmaz, M., Balcı, C., Aydın, U., & Laganà, A. S. (2020). Impact of bupivacaine injection to trocar sites on postoperative pain following laparoscopic hysterectomy: Results from a prospective, multicentre, double-blind randomized controlled trial. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 252, 317-322. https://doi.org/10.1016/j.ejogrb.2020.07.007
Hortu I, et al. Impact of Bupivacaine Injection to Trocar Sites On Postoperative Pain Following Laparoscopic Hysterectomy: Results From a Prospective, Multicentre, Double-blind Randomized Controlled Trial. Eur J Obstet Gynecol Reprod Biol. 2020 Jul 7;252:317-322. PubMed PMID: 32653604.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of bupivacaine injection to trocar sites on postoperative pain following laparoscopic hysterectomy: Results from a prospective, multicentre, double-blind randomized controlled trial. AU - Hortu,Ismet, AU - Turkay,Unal, AU - Terzi,Hasan, AU - Kale,Ahmet, AU - Yılmaz,Mehmet, AU - Balcı,Canan, AU - Aydın,Umit, AU - Laganà,Antonio Simone, Y1 - 2020/07/07/ PY - 2020/04/12/received PY - 2020/06/30/revised PY - 2020/07/02/accepted PY - 2020/7/13/pubmed PY - 2020/7/13/medline PY - 2020/7/13/entrez KW - Bupivacaine KW - Local anaesthetics KW - Postoperative pain KW - Total laparoscopic hysterectomy SP - 317 EP - 322 JF - European journal of obstetrics, gynecology, and reproductive biology JO - Eur. J. Obstet. Gynecol. Reprod. Biol. VL - 252 N2 - OBJECTIVES: Laparoscopic surgery has numerous advantages over open surgery in view of postoperative pain. In this context, to elevate its benefits and patient satisfaction, different pain management interventions have been used so far. This study aimed to evaluate the effect of bupivacaine injection to trocar sites following laparoscopic hysterectomy for the management of postoperative pain. STUDY DESIGN: In this study, patients were randomized into two groups (56 cases; 52 controls). A single injection of bupivacaine (0.5 %, 5 mg/mL) was introduced to trocar sites under subcutaneous tissue at a dose of 4 ml for the umbilicus and 2 ml for each 5-mm ancillary trocar site in the study group. No bupivacaine was administered to the control group. The primary aim was to measure differences in 2 -h postoperative numerical rating scale (NRS) pain scores between the two groups. The secondary aims were to evaluate differences between 1-, 4-, 6-, 24- and 48 -h postoperative NRS pain scores, surgical complications, estimated blood loss, duration of operation and analgesic consumption. RESULTS: The number of postoperative rescue doses of analgesics was found to be lower in the study group compared to the control group (median of 2 vs. 4; p < 0.01). The 1-, 4-, 6-, 24- and 48-hour postoperative NRS pain scores were also found to be lower in the study group compared to the control group (p < 0.01 at each follow-up). The mean duration of surgery and uterus removal, as well as the estimated blood loss, were not significantly different between the two groups. CONCLUSIONS: The present study suggests that bupivacaine injection to trocar sites is an effective and safe method for reducing pain following laparoscopic hysterectomy. SN - 1872-7654 UR - https://www.unboundmedicine.com/medline/citation/32653604/Impact_of_bupivacaine_injection_to_trocar_sites_on_postoperative_pain_following_laparoscopic_hysterectomy:_Results_from_a_prospective,_multicentre,_double-blind_randomized_controlled_trial L2 - https://linkinghub.elsevier.com/retrieve/pii/S0301-2115(20)30447-4 DB - PRIME DP - Unbound Medicine ER -
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