Efficacy of continuous wound infiltration of local anesthetic for pain relief after gynecologic laparoscopy

• Published in: International journal of gynecology and obstetrics 2014-03, Vol.124 (3), p.212-215
• Main Authors: Kong, Tae-Wook, Park, Hyogyeong, Cheong, Ji-Yoon, Min, Sang-Ki, Ryu, Hee-Sug
• Format: Article
• Language: English
• Subjects: Adult; Amides - administration & dosage; Amides - adverse effects; Analgesia, Patient-Controlled - adverse effects; Analgesia, Patient-Controlled - methods; Analgesics, Opioid - administration & dosage; Analgesics, Opioid - adverse effects; Anesthetics, Local - administration & dosage; Anesthetics, Local - adverse effects; Continuous ropivacaine wound infiltration; Female; Fentanyl - administration & dosage; Fentanyl - adverse effects; Gynecologic laparoscopy; Gynecologic Surgical Procedures - adverse effects; Gynecologic Surgical Procedures - methods; Humans; Infusions, Intralesional; Ketorolac - administration & dosage; Ketorolac - adverse effects; Laparoscopy - adverse effects; Laparoscopy - methods; Middle Aged; Obstetrics and Gynecology; Pain Measurement; Pain, Postoperative - drug therapy; Pain, Postoperative - etiology; Postoperative Nausea and Vomiting - epidemiology; Postoperative pain; Prospective Studies; Republic of Korea; Treatment Outcome
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1016/j.ijgo.2013.08.019

Abstract Objective To assess the efficacy of analgesia provided by continuous ropivacaine wound infiltration after gynecologic laparoscopy. Methods Sixty patients who underwent gynecologic laparoscopy at Ajou University School of Medicine, Suwon, Republic of Korea, between March and May 2012 were randomized to receive either intravenous fentanyl and ketorolac infusion on demand by patient-controlled analgesia (IV PCA group, n = 31) or continuous wound infiltration of local ropivacaine (CWI group, n = 29). Postoperative pain and postoperative nausea and vomiting (PONV) were assessed via a visual analog scale. The number of patients who requested rescue analgesia was recorded. Results There was no significant difference in postoperative pain between the 2 groups, but more patients requested rescue analgesia in the CWI group than in the IV PCA group in 24 hours (18 versus 9 patients, respectively; P = 0.010). The PONV scores at 12 and 24 hours were, respectively, 0.28 and 0.27 in the CWI group, and 0.71 and 0.73 in the IV PCA group ( P = 0.004). Nine patients requested cessation of IV PCA because of severe nausea or vomiting. Conclusion Continuous ropivacaine wound infiltration was found to be as effective as patient-controlled analgesia for postoperative pain relief after gynecologic laparoscopy. This technique provides good analgesia with less opioid analgesic requirement and few adverse effects.