Effectiveness of local anesthetic on postoperative pain in different levels of laparoscopic gynecological surgery

• Published in: Archives of gynecology and obstetrics 2016-06, Vol.293 (6), p.1279-1285
• Main Authors: Selcuk, Selcuk, Api, Murat, Polat, Mesut, Arinkan, Arzu, Aksoy, Bilge, Akca, Tijen, Karateke, Ates
• Format: Article
• Language: English
• Subjects: Adult; Aged; Analgesia; Anesthesia, Local; Anesthetics, Local - administration & dosage; Anesthetics, Local - pharmacology; Double-Blind Method; Endocrinology; Female; General Gynecology; Gynecologic Surgical Procedures; Gynecology; Human Genetics; Humans; Laparoscopy; Laparoscopy - methods; Lidocaine - administration & dosage; Lidocaine - pharmacology; Local anesthesia; Male; Medicine; Medicine & Public Health; Middle Aged; Obstetrics/Perinatology/Midwifery; Pain; Pain Measurement; Pain, Postoperative - drug therapy; Postoperative Period; Prospective Studies; Surgery; Treatment Outcome; Turkey
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-015-3984-7

Purpose The aim of this study was to assess the effects of preemptive and preclosure analgesia on postoperative pain intensity in patients undergoing different levels of laparoscopic surgery. Methods Two hundred and twenty-six patients who underwent laparoscopic gynecological surgery were enrolled in this quasi-randomized, prospective, placebo controlled study. The operations were classified as level 1 or level 2 according to the extent of the surgery. Lidocaine 1 % was administered at the port sites before making the incision in the preincisional study group. In preincisional control group, same amount of saline was infiltrated in same manner. Lidocaine 1 % was infiltrated at the port site immediately after removing the trocars in preclosure study group. In preclosure control group, the same amount of saline was infiltrated in the same manner. Postoperative pain intensity was evaluated by linear visual analogue scale. Results It was found that preclosure lidocaine infiltration was more effective on postoperative pain intensity than its placebo group in level 1 and level 2 surgery groups at 1 and 2 h postoperatively. The administration of preincisional lidocaine improved postoperative pain scores significantly more than its placebo group in level 1 laparoscopic surgery group at 1 and 2 h postoperatively and in level 2 laparoscopic surgery group at 1 h postoperatively. Conclusion Lidocaine infiltration at port sites had beneficial effects on pain intensity in the early postoperative period after laparoscopic gynecological surgery. However, the results of present study showed that the analgesic effect mechanism of local anesthetic was unrelated to the preemptive analgesia hypothesis.