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KMID : 0358420170600050455
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Korean Journal of Obstetrics and Gynecology
2017 Volume.60 No. 5 p.455 ~ p.461
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Port site infiltration of local anesthetic after laparoendoscopic single site surgery for benign adnexal disease
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Kim Jung-Eun
Shim Seung-Hyuk
Dong Me-A-Ri
Lee Hyo-Jin
Hwang Han-Sung
Kwon Han-Sung
Lee Sun-Joo
Lee Ji-Young
Sohn In-Sook
Kim Soo-Nyung
Kang Soon-Beom
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Abstract
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Objective: To determine whether local bupivacaine injection into the incision site after gynecologic laparoendoscopic single site surgery (LESS) improves postoperative pain.
Methods: This prospective cohort study included consecutive 158 patients who had LESS for benign adnexal disease from March 2013 to December 2015. Chronologically, 82 patients (March 2013 to August 2014) received no bupivacaine (group 1) and 76 (August 2014 to December 2015) received a bupivacaine block (group 2). For group 2, 10 mL 0.25% bupivacaine was injected into the 20 mm-incision site through all preperitoneal layers after LESS completion. Primary outcome is postoperative pain score using the visual analog scale (VAS).
Results: There was no difference in clinicopathological characteristics between the groups. Operating time (expressed as median [range], 92 [55?222] vs. 100 [50?185] minutes, P=0.137) and estimated blood loss (50 [30?1,500] vs. 125 [30?1,000] mL, P=0.482) were similar between the groups. Post-surgical VAS pain scores after 3 hours (3.5 [2?6] vs. 3.5 [2?5], P=0.478), 6 to 8 hours (3.5 [2?6] vs. 3 [1?8], P=0.478), and 16 to 24 hours (3 [2?4] vs. 3 [1?7], P=0.664) did not differ between groups.
Conclusion: Bupivacaine injection into the trocar site did not improve postoperative pain after LESS. Randomized trials are needed to evaluate the benefits of local bupivacaine anesthetic for postoperative pain reduction.
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KEYWORD
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Local anesthesia, Laparoscopy, Pain, Minimally invasive surgical procedures
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