The Role of Local Anesthesia Instillation in Pain Alleviation Post Laparoscopy

Abstract

Background: Gynecological laparoscopy is now becoming a more popular technique for diagnosis and treatment of infertility cases; however gynecological laparoscopy is usually followed by Post-operative pain which may be attributed to small incision in abdominal wall or as a result of diaphragmatic irritation by inflating gases. Aim of the Study: was to assess the role of local anesthesia instillation in pain relief after laparoscopy. Patients and methods: the present study was a randomized trial study performed on 146 women aged 20-35 years, admitted to Ain Shams University hospitals. Patients were split into 2 equal groups, Group(A): further subdivided into A1 and A2 whom undergone diagnostic and operative laparoscopy respectively- patients administrated 20ml of 0.25% of Bupivacaine instilled intraperitoneal-and Group (B): further subdivided into B1 and B2 -whom undergone diagnostic and operative laparoscopy respectively-Patients administrated 20ml of 0.75% of Ropivacaine instilled intra-peritoneal. Vital signs and Pain scores were measured preoperatively, immediate postoperative, 1 hours, 2 hours, 4 hours, 8 hours, 12 hours postoperatively. Data was collected, tabulated, then analyzed using IBM© SPSS© Statistics version 22 (IBM© Corp., Armonk, NY). Results: administration of 20mL of Ropivacaine 0.75% at the end of technique gave pain relief for four hours in group B1 and pain relief for three hours in group B2, associated with an increase in heart rate and blood pressure for two hours in group B1 and B2 for three hours. Conclusion: instillation of local anesthetic after laparoscopy promotes pain relief post operatively and further minimizes the postoperative hospital stay.