1206 The Effect of Sub-Cutaneous and Intra-Peritoneal Anesthesia on Post Laparoscopic Pain: A Randomized Controlled Trial

Abstract

Study Objective To evaluate whether sub-cutaneous (SC) trocar site and intra-peritoneal (IP) anesthesia reduce post-operative pain. Design This is a randomized, controlled, double-blinded trial. The patients were randomly assigned to one of 4 groups: Group 1-SC and IP anesthesia; Group 2- SC anesthesia and IP placebo; Group 3- SC placebo and IP anesthesia; Group 4- SC and IP placebo. The patients, surgeons, and pain evaluators were all blinded to the patient's allocation. Setting A single tertiary hospital. Patients or Participants Patients who underwent elective laparoscop and gave their informed consent. Exclusion criteria were: malignancy, active infection, pregnancy, known sensitivity to Bupivacaine-Hydrochloride, chronic pelvic pain, conversion to laparotomy, or additional vaginal procedures. Interventions A total of 9 ml of Bupivacaine-Hydrochloride (Marcaine) 0.5%, or Sodium-Chloride 0.9%, as a placebo, were injected sub-cutaneously to the trocar site, prior to skin incision. In addition, 10 ml of Bupivacaine-Hydrochloride 0.5%, diluted with 40 ml of Sodium-Chloride 0.9%, or 50 ml of Sodium-Chloride 0.9%, as a placebo, were injected intra-peritoneally at the end of the surgery. Measurements and Main Results By using 10 cm Visual-analogue-scale (VAS) we assessed the pain at rest at 3, 8, and 24 hours, and pain during movement at 8 and 24 hours after surgery. One hundred and twenty women were included (30 patients in each). Demographic data, as well as operations' characteristics, were similar between the groups. The level of post-operative pain, either at rest or movement, was not significantly different between the groups, in all points of time. There were also no differences in pain levels when all SC analgesia groups (1&2) were compared to all SC placebo groups (3&4), and when all IP analgesia groups (1&3) were compared to all IP placebo groups (2&4). Conclusion Sub-cutaneous and/ or intra-peritoneal anesthesia were not effective in reducing post-operative pain. To evaluate whether sub-cutaneous (SC) trocar site and intra-peritoneal (IP) anesthesia reduce post-operative pain. This is a randomized, controlled, double-blinded trial. The patients were randomly assigned to one of 4 groups: Group 1-SC and IP anesthesia; Group 2- SC anesthesia and IP placebo; Group 3- SC placebo and IP anesthesia; Group 4- SC and IP placebo. The patients, surgeons, and pain evaluators were all blinded to the patient's allocation. A single tertiary hospital. Patients who underwent elective laparoscop and gave their informed consent. Exclusion criteria were: malignancy, active infection, pregnancy, known sensitivity to Bupivacaine-Hydrochloride, chronic pelvic pain, conversion to laparotomy, or additional vaginal procedures. A total of 9 ml of Bupivacaine-Hydrochloride (Marcaine) 0.5%, or Sodium-Chloride 0.9%, as a placebo, were injected sub-cutaneously to the trocar site, prior to skin incision. In addition, 10 ml of Bupivacaine-Hydrochloride 0.5%, diluted with 40 ml of Sodium-Chloride 0.9%, or 50 ml of Sodium-Chloride 0.9%, as a placebo, were injected intra-peritoneally at the end of the surgery. By using 10 cm Visual-analogue-scale (VAS) we assessed the pain at rest at 3, 8, and 24 hours, and pain during movement at 8 and 24 hours after surgery. One hundred and twenty women were included (30 patients in each). Demographic data, as well as operations' characteristics, were similar between the groups. The level of post-operative pain, either at rest or movement, was not significantly different between the groups, in all points of time. There were also no differences in pain levels when all SC analgesia groups (1&2) were compared to all SC placebo groups (3&4), and when all IP analgesia groups (1&3) were compared to all IP placebo groups (2&4). Sub-cutaneous and/ or intra-peritoneal anesthesia were not effective in reducing post-operative pain.