OBJECTIVE: To assess the effect of systematic local infiltration analgesia on postoperative pain in vaginal hysterectomy, and describe the technique in detail. DESIGN: A randomized, double-blind, placebo-controlled study following the CONSORT criteria. SETTING: A university hospital. PATIENTS: Thirty-seven patients undergoing vaginal hysterectomy. METHODS: Patients received high-volume (50 mL) ropivacaine 0.50% (n = 20) or saline (n = 17) infiltration using a systematic technique ensuring uniform delivery to all tissues incised, handled or instrumented during the procedure. MAIN OUTCOME MEASURES: Pain, nausea, vomiting and opioid requirements were assessed for 32 h as well as time spent in the post-anesthesia care unit and time to first mobilization. RESULTS:Pain at rest was significantly reduced after one, four and eight hours in the ropivacaine group (p ≤ 0.001-0.01). Pain during coughing was significantly reduced after one and four hours (p ≤ 0.001 and p ≤ 0.003), and pain during movement was significantly reduced after four hours (p ≤ 0.02). Opioid requirements and time spent in the post-anesthesia care unit were significantly reduced in the ropivacaine group (p < 0.001 and p < 0.001, respectively), as well as the time to first mobilization (p < 0.001). CONCLUSION: Intra-operative systematic local infiltration analgesia reduces postoperative pain in patients undergoing vaginal hysterectomy, facilities mobilization and improves early recovery.
RCT Entities:
OBJECTIVE: To assess the effect of systematic local infiltration analgesia on postoperative pain in vaginal hysterectomy, and describe the technique in detail. DESIGN: A randomized, double-blind, placebo-controlled study following the CONSORT criteria. SETTING: A university hospital. PATIENTS: Thirty-seven patients undergoing vaginal hysterectomy. METHODS:Patients received high-volume (50 mL) ropivacaine 0.50% (n = 20) or saline (n = 17) infiltration using a systematic technique ensuring uniform delivery to all tissues incised, handled or instrumented during the procedure. MAIN OUTCOME MEASURES: Pain, nausea, vomiting and opioid requirements were assessed for 32 h as well as time spent in the post-anesthesia care unit and time to first mobilization. RESULTS:Pain at rest was significantly reduced after one, four and eight hours in the ropivacaine group (p ≤ 0.001-0.01). Pain during coughing was significantly reduced after one and four hours (p ≤ 0.001 and p ≤ 0.003), and pain during movement was significantly reduced after four hours (p ≤ 0.02). Opioid requirements and time spent in the post-anesthesia care unit were significantly reduced in the ropivacaine group (p < 0.001 and p < 0.001, respectively), as well as the time to first mobilization (p < 0.001). CONCLUSION: Intra-operative systematic local infiltration analgesia reduces postoperative pain in patients undergoing vaginal hysterectomy, facilities mobilization and improves early recovery.
Authors: R Likar; W Jaksch; T Aigmüller; M Brunner; T Cohnert; J Dieber; W Eisner; S Geyrhofer; G Grögl; F Herbst; R Hetterle; F Javorsky; H G Kress; O Kwasny; S Madersbacher; H Mächler; R Mittermair; J Osterbrink; B Stöckl; M Sulzbacher; B Taxer; B Todoroff; A Tuchmann; A Wicker; A Sandner-Kiesling Journal: Schmerz Date: 2017-10 Impact factor: 1.107
Authors: G Nelson; A D Altman; A Nick; L A Meyer; P T Ramirez; C Achtari; J Antrobus; J Huang; M Scott; L Wijk; N Acheson; O Ljungqvist; S C Dowdy Journal: Gynecol Oncol Date: 2016-01-03 Impact factor: 5.482
Authors: Joon-Hyop Lee; Yong Joon Suh; Ra-Yeong Song; Jin Wook Yi; Hyeong Won Yu; Hyungju Kwon; June Young Choi; Kyu Eun Lee Journal: Medicine (Baltimore) Date: 2017-06 Impact factor: 1.889