Intraperitoneal Instillation Research Articles

Humanized theta-defensins (retrocyclins) enhance macrophage performance and protect mice from experimental anthrax infections.

Retrocyclins are humanized versions of the -defensin peptides expressed by the leukocytes of several nonhuman primates. Previous studies, performed in serum-free media, determined that retrocyclins 1 (RC1) and RC2 could prevent successful germination of Bacillus anthracis spores, kill vegetative B. anthracis cells, and inactivate anthrax lethal factor. We now report that retrocyclins are extensively bound by components of native mouse, human, and fetal calf sera, that heat-inactivated sera show greatly enhanced retrocyclin binding, and that native and (especially) heat-inactivated sera greatly reduce the direct activities of retrocyclins against spores and vegetative cells of B. anthracis. Nevertheless, we also found that retrocyclins protected mice challenged in vivo by subcutaneous, intraperitoneal, or intranasal instillation of B. anthracis spores. Retrocyclin 1 bound extensively to B. anthracis spores and enhanced their phagocytosis and killing by murine RAW264.7 cells. Based on the assumption that spore-bound RC1 enters phagosomes by "piggyback phagocytosis," model calculations showed that the intraphagosomal concentration of RC1 would greatly exceed its extracellular concentration. Murine alveolar macrophages took up fluorescently labeled retrocyclin, suggesting that macrophages may also acquire extracellular RC1 directly. Overall, these data demonstrate that retrocyclins are effective in vivo against experimental murine anthrax infections and suggest that enhanced macrophage function contributes to this property.

Randomized clinical trial of combined preincisional infiltration and intraperitoneal instillation of levobupivacaine for postoperative pain after laparoscopic cholecystectomy (Br J Surg 2011; 98: 784–789)

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Authors' reply: Randomized clinical trial of combined preincisional infiltration and intraperitoneal instillation of levobupivacaine for postoperative pain after laparoscopic cholecystectomy (Br J Surg 2011; 98: 784–789)

Authors' reply: Randomized clinical trial of combined preincisional infiltration and intraperitoneal instillation of levobupivacaine for postoperative pain after laparoscopic cholecystectomy (<i>Br J Surg</i> 2011; 98: 784–789)

Peritrocal and Intraperitoneal Ropivacaine for Laparoscopic Cholecystectomy: A Prospective, Randomized, Double-Blind Controlled Trial

The goal of this study was to evaluate the effect of peritrocal, intraperitoneal, or combined peritrocal-intraperitoneal ropivacaine on the parietal, visceral, and shoulder tip pain after laparoscopic cholecystectomy. Eighty patients were randomly assigned to four groups. Group A received peritrocal and intraperitoneal saline. Group B received peritrocal saline and intraperitoneal ropivacaine. Group C received peritrocal ropivacaine and intraperitoneal saline. Group D received peritrocal and intraperitoneal ropivacaine. The parietal, visceral, and shoulder tip pain were assessed at 2, 4, 8, 12, 24, and 48 h postoperatively using a visual analog scale (VAS). The frequency of the patient pushing the button of the PCA and fentanyl use were also recorded. In visceral pain, significantly lower VAS scores were observed in Group B from 2 to 4 h and in Group D from 2 to 8 h. In parietal pain, significantly lower VAS scores were observed in Group C from 4 to 24 h and in Group D from 2 to 12 h. In shoulder tip pain, significantly lower VAS scores were observed in Group B from 4 to 48 h and in Group D from 2 to 12 h. The fentanyl use and the frequency to push the button of the PCA were the highest in Group A and the lowest in Group D at every time point. We conclude that peritrocal infiltration of ropivacaine significantly decreases parietal pain and intraperitoneal instillation of ropivacaine significantly decreases the visceral and shoulder tip pain. Their effects are additive with respect to the total pain.

Intraperitoneal and intravenous lidocaine for effective pain relief after laparoscopic appendectomy: a prospective, randomized, double-blind, placebo-controlled study

The preemptive intravenous and intraperitoneal application of local anesthetics is known to improve the postoperative outcome in abdominal surgery. The aim of this study was to compare the analgesic effect of intravenous lidocaine injection to that of intraperitoneal lidocaine instillation in patients who were undergoing laparoscopic appendectomy (LA). Sixty-eight patients who were undergoing LA for unperforated appendicitis were randomly divided into three groups. Group IP (the intraperitoneal instillation group) received intraperitoneal instillation of lidocaine and intravenous normal saline injection. Group IV (the intravenous injection group) received intravenous lidocaine injection and intraperitoneal instillation of normal saline. In group C (the placebo control group), normal saline was given both intravenously and intraperitoneally. The visual analog scale (VAS) of pain scores was measured after surgery. The needs for additional intravenous fentanyl were evaluated and the integrated fentanyl consumption (PCA delivered + additional fentanyl) was assessed. The incidence of shoulder tip pain and postoperative nausea and vomiting (PONV) were noted. Reduction of the VAS score and of fentanyl consumption was noted in the IV and IP groups and compared to that of group C (P < 0.05). The shoulder tip pain and PONV were reduced in groups IP and IV compared to that in group C (P < 0.05). However, no significant differences were found between the IP and IV groups for all the studied variables. There was no adverse effect from intravenous lidocaine throughout the study. Intravenous lidocaine injection is as effective as intraperitoneal instillation for reducing pain and fentanyl consumption. The major benefit of intravenous injection is that this is an easily and universally applicable procedure compared to that of intraperitoneal instillation. Lidocaine intravenous administration is a better alternative for reducing the pain of patients who are undergoing laparoscopic surgery.

Randomized clinical trial of combined preincisional infiltration and intraperitoneal instillation of levobupivacaine for postoperative pain after laparoscopic cholecystectomy

Postoperative pain is one of the main reasons for a prolonged hospital stay after laparoscopic cholecystectomy (LC). Reduced postoperative pain might result in faster recovery and establish LC as a day-care surgical procedure. Peroperative local anaesthesia has been suggested to reduce postoperative pain. The aim of this study was to determine the effect of combined subcutaneous infiltration and intraperitoneal instillation of levobupivacaine before the start of LC on postoperative abdominal pain up to 24 h after surgery. Patients eligible for elective LC were randomized to receive preincisional infiltration and preoperative intraperitoneal instillation of 80 ml of either 0·125 per cent levobupivacaine (experimental group) or normal saline (placebo group). The primary outcome measure was abdominal pain estimated by means of a visual analogue scale at 0·5, 2, 4, 8 and 24 h after surgery. Eighty of the 101 patients assessed for eligibility were randomized. There was no significant reduction in postoperative abdominal pain with levobupivacaine compared with placebo during the 24-h follow-up; the overall difference in pain score was 2·2 (95 per cent confidence interval - 4·9 to 9·3; P = 0·540). The duration of operation, use of anaesthesia, use of rescue analgesia, shoulder pain, duration of hospital stay and time to resumption of normal daily activities did not differ between the two groups. Combined subcutaneous and intraperitoneal administration of levobupivacaine did not influence postoperative abdominal pain after LC. NCT01199406 (http://www.clinicaltrials.gov).

Effect of Perfluorohexane on the Expression of Cellular Adhesion Molecules and Surfactant Protein A in Human Mesothelial Cells In Vitro

The intraperitoneal instillation of perfluorocarbons augmented systemic oxygenation and was protective in mesenteric ischemia-reperfusion and experimental lung injury. To study biocompatibility and potential anti-inflammatory effects of intraperitoneal perfluorocarbons, we evaluated the influence of perfluorohexane and/or inflammatory stimuli on human mesothelial cells in vitro. Perfluorohexane exposure neither impaired cell viability nor induced cellular activation. TNFα enhanced ICAM-1 expression, which was not attenuated by simultaneous perfluorohexane treatment. Concentration of intracellular surfactant protein A tended to be higher in perfluorohexane treated cells compared to controls. Our in vitro data add further evidence that intraperitoneal perfluorocarbon application is feasible without adverse local effects.

Positive experience of intraperitoneal chemotherapy followed by intravenous chemotherapy in heavily pretreated patients with suboptimal residual ovarian cancer and primary peritoneal cancer.

To assess feasibility and toxicity of intraperitoneal administration of cisplatin and paclitaxel, followed by intravenous chemotherapy in pretreated patients with suboptimal ovarian cancer (residuum >1 cm) or primary peritoneal tumor, and suffering from ascites and/or intestinal obstruction. Fourteen relapsed ovarian cancer patients, 5 of whom were platinum sensitive (platinum-free interval >6 mo), 7 platinum-resistant (platinum-free interval <6 mo), and 2 platinum-refractory, received one cycle of intraperitoneal cisplatin, 100 mg/m2 on day 1, and two cycles of intraperitoneal paclitaxel, 120 mg/m2 on days 8 and 14. Intravenous chemotherapy was administrated 4 weeks following the last intraperitoneal paclitaxel instillation. Blood and peritoneal fluid samples were harvested at 0, 1, 4 and 24 h after ending paclitaxel delivery to guarantee proper tumor exposure and patient safety. Intraperitoneal cisplatin determined 6 cases of vomiting grade 1-2 (40% of the morbidity). Intraperitoneal paclitaxel was associated with 6 events of grade 1-2 abdominal pain; the only grade 4 toxicity was one case of neutropenia and one of mucositis. Ascites decreased in 11 patients: the median time to first need for paracentesis was 5 months, compared to a median baseline paracentesis of 4 weeks. Three intestinal normalizations were obtained. The median overall survival was 10 months for our cohort of patients. Intraperitoneal paclitaxel clearance was significantly higher in patients with suboptimal tumor and symptomatic disease than in patients with smaller residual masses and without ascites (P = 0.004). Intraperitoneal treatment was feasible, and enhanced response to the following intravenous chemotherapy was seen in these patients.

Nebulization of local anaesthetics in laparoscopic surgery: A new tool for postoperative analgesia

Laparoscopic procedures have been associated to moderate or severe pain that may require opioids and almost all patients referred shoulder pain. Intraperitoneal instillation of local anaesthetics, as part of a multimodal approach analgesia program, reduces pain intensity and morphine consumption after laparoscopic cholecystectomy. However, direct local anesthetic instillation is not enough to eliminate visceral and shoulder pain. Heated and humidified gas may produce positive effects such as reduction of postoperative pain. Intraperitoneal nebulization, a new technique of drug administration, provides homogeneous spread of drugs allowing a better distribution of local anaesthetics throughout the peritoneum. This technique combines the effects of gas conditioning and the analgesic benefits of local anaesthetic instillation. Nebulization of local anaesthetics during different laparoscopic procedures reduced postoperative pain, morphine consumption and allowed earlier mobilization. Future studies should determine, the optimal dose of local anaesthetics, the effect of local anaesthetic nebulization in different clinical settings and its importance on long term clinical outcomes.

Single Incision Diagnostic Laparoscopy in a Patient With Sclerosing Peritonitis

Sclerosing peritonitis (SP) is a rare disease that can cause abdominal pain and intestinal obstruction. SP can be primary (also called abdominal cocoon) or secondary (when it is mainly due to systemic diseases or the intraperitoneal instillation of medications). We report the video of a single incision diagnostic laparoscopy in a patient with SP with the educational intent of allowing easier recognition of this rare disease. The patient is a 72-year-old female with a history of bladder cancer, salivary gland cancer, and squamous cell cancer of the skin. She was diagnosed with a suspicion of SP during a diagnostic laparoscopy made to rule out ovarian cancer at an outside institution. Due to worsening of her symptoms, she was presented to our hospital for a second opinion. Due to inadequate tissue from her first exploration, she was brought to the operating room for a diagnostic laparoscopy. Although SP can mimic the gross appearance of peritoneal carcinomatosis, multiple biopsies should be obtained to allow for the diagnosis of SP. This video shows how this rare disease entity can present and how an abdomen with even thick fibrosis can be managed with a minimally invasive approach.

The Pharmacokinetics of Ropivacaine After Intraperitoneal Administration

Intraperitoneal local anesthetic administration provides perioperative analgesia during laparoscopic procedures. We compared the pharmacokinetics of intraperitoneal ropivacaine administered by instillation or nebulization. A crossover study was performed on 5 pigs under standardized general anesthesia with a carbon dioxide pneumoperitoneum of 12 mm Hg for 1 hour. Each animal, acting as its own control, was studied twice with an 8-day interval and received, in a randomized sequence, 3 mg/kg ropivacaine either by intraperitoneal instillation at the time of pneumoperitoneum exsufflation or by continuous nebulization in the carbon dioxide insufflation tubing. Arterial blood samples were taken every 10 minutes up to 120 minutes, and then hourly up to 6 hours. Ropivacaine concentrations were measured using high-performance liquid chromatography with ultraviolet-visible detection. The plasma-free fraction was evaluated after plasma ultracentrifugation. Pharmacokinetic parameters were calculated using both noncompartmental and compartmental analysis. The mean values were compared using the Student t test, or Wilcoxon test for paired series. The data were described by a 1-compartment model for both ropivacaine administration techniques, with a delay of 10 minutes for the nebulization group. The maximal ropivacaine concentrations were 0.96 μg/mL for the nebulization group and 0.92 μg/mL for the instillation group (P = 0.66). The ropivacaine absorption constant was lower in the nebulization group (0.043 vs 0.083 min(-1), P = 0.02). There were no differences in the elimination half-life, elimination constant, mean total body clearance, distribution volume, mean area under the curve, and mean residence time. The free fraction of ropivacaine was also similar in the 2 groups. The pharmacokinetic profile of ropivacaine nebulization is similar to direct intraperitoneal instillation, but with a lower absorption rate.

Intraperitoneal Ropivacaine for Effective Pain Relief after Laparoscopic Appendectomy: A Prospective, Randomized, Double-blind, Placebo-controlled Study

This prospective, randomized, doubleblind, placebo-controlled study evaluated the effectiveness of intraperitoneal instillation of ropivacaine in the relief of pain in patients undergoing laparoscopic appendectomy. Patients in group C (placebo control group; n = 33) received normal saline and those in group I (instillation group; n = 30) received an instillation of 2 mg/kg ropivacaine at the initiation of the pneumoperitoneum. Visual analogue scale pain scores, fentanyl consumption and the frequency at which patients pushed the button (FPB) of a patient-controlled analgesia system during the post-operative period were significantly lower in group I compared with group C, and decreased gradually with time in both groups. The total amount of fentanyl consumed and the total FPB were significantly lower in group I compared with group C. Thus, intraperitoneal ropivacaine instillation reduced pain during the post-operative period after laparoscopic appendectomy. In addition, this drug was easy to administer and had no adverse effects at the dose used.

A Case Report: Vesico-Rectal Fistula with Ano-Urethral Atresia

Vesico-rectal fistula is a rare congenital abnormality causing severe early second trimester oligohydramnios. Prenatal diagnosis of such a case is reported here. Ultrasound diagnosis could be aided by transabdominal amnio-infusion and, if necessary, fetal intraperitoneal saline installation. In a karyotypically normal fetus with normal somatic growth, demonstration of normal fetal kidneys together with a functioning urinary bladder, in presence of severe oligohydramnios, is very suggestive of the diagnosis. Since pulmonary hypoplasia is the major cause of neonatal mortality in these cases, restoration of normal amniotic fluid volume by serial amnio-infusion was attempted. Although amnio-infusion is an important diagnostic aid in the evaluation of severe midtrimester oligohydramnios, the role of multiple therapeutic amnio-infusion in improving lung growth remains to be evaluated.

The Effect of Intraperitoneal Ropivacaine on Pain after Laparoscopic Colectomy: A Prospective Randomized Controlled Trial

Although laparoscopic procedures are becoming more common, postoperative pain remains a major factor causing delayed patient recovery. There have been several trials to reduce pain by instilling local anesthetics into the peritoneal cavity, but there has been no study on prolonged (∼300 min) or intensive surgery. We investigated the analgesic effect of intraperitoneal ropivacaine instillation after laparoscopic colectomy. Sixty patients were randomized to three groups. Twenty patients in each group received 50 mL of appropriate solutions after the formation of a pneumoperitoneum. The solution was normal saline (control) in group C and 1 mg/kg of ropivacaine in each of groups I and D. In group D, ropivacaine was sprayed again before the elimination of the pneumoperitoneum. Patients reported their postoperative pain using a subjective visual analogue scale. Fentanyl use for pain relief and frequency of pushing a button (FPB) for a bolus of patient controlled analgesia were evaluated, and scales of recovery rates were obtained. The immediate postoperative pain score was lower in groups I and D than in group C. In groups I and D, FPB measures and fentanyl use were both less than in group C. The time taken to resume a regular diet was shorter in group D than in group C. The intraperitoneal instillation of ropivacaine was effective in reducing postoperative pain and in shortening the recovery course after laparoscopic colectomy. The additional instillation of ropivacaine at the end of the surgery proved even more effective.

A Novel Physiologic Model for the Study of Abdominal Compartment Syndrome (ACS)

: Current abdominal compartment syndrome (ACS) models rely on intraperitoneal instillation of fluid, air, and other space-occupying substances. Although this allows for the study of the effects of increased abdominal pressure, it poorly mimics its pathogenesis. We have developed the first reported large animal model of ACS incorporating hemorrhagic shock/resuscitation. : Hemorrhagic shock was induced and maintained (1 hour) in 12 Yorkshire swine by bleeding to a mean arterial pressure (MAP) of 50 mm Hg. The collected blood plus two additional volumes of crystalloid was then reinfused. Mesenteric venous hypertension was induced by tightening a previously placed portal vein snare in a nonocclusive manner to mimic the effects of abdominal packing. Crystalloids were infused to maintain MAP. Hemodynamic measurements, abdominal pressure, peak inspiratory pressures, urine output, and blood chemistries were measured sequentially. Animals were studied for 36 hours after decompression. : ACS (intra-abdominal pressure of > or =20 mm Hg with new organ dysfunction) developed in all animals. There were significant increases in peak inspiratory pressure, central venous pressure, and pulmonary artery pressure and decreases in MAP upon development of ACS. Urine output was significantly decreased before decompression. Mean blood lactate decreased and base excess increased significantly after decompression. : We have created the first reported physiologic animal ACS model incorporating hemorrhagic shock/resuscitation and the effects of damage control surgery.

Intraperitoneal Lidocaine Instillation and Postcesarean Pain After Parietal Peritoneal Closure

To evaluate the effects of intraperitoneal instillation of lidocaine on postcesarean pain in patients with pariental periotoneal closure. A sample of 370 pregnant women, presenting early in labor, with no history of abdominal surgery and with indications for cesarean section were operated on with closure of the parietal peritoneum. They randomly received either 200 mg of intraperitoneal lidocaine or sterile saline (0.9%). Pain scores on the first and fifteenth postoperative days were recorded and followed up every 2 weeks up to 8 months after surgery. Overall incidence and pain scores of epigastric and global abdominal pain were more frequent in the controls than in the lidocaine group. The incidence of persistent postcesarean pain after 8 months dropped from 20.8.0% to 10.8% (P<0.001) when intraperitoneal lidocaine was instilled. Intraperitoneal instillation of 200 mg of lidocaine decreased the incidence and scores of postcesarean pain when the parietal peritoneum was sutured. Further studies in a setting offering more effective acute pain control protocols, preferably with patient-controlled analgesia, are recommended to assess the use of lidocaine before it can be widely practiced.

Intraperitoneal Ropivacaine Instillation for Postoperative Pain Relief after Laparoscopic Cholecystectomy

Purpose: A study was designed to assess the effect of intraperitoneal instillation of ropivacaine in larparoscopic cholecystectomy patients using computerized patient controlled anesthesia (PCA). Methods: From January 2009 to June 2009, 40 patients with uncomplicated, symptomatic cholecystitis with cholelithiasis who were referred to Chung-Ang University Medical Center for laparoscopic cholecystectomy were included in the study. Patients in group C (control group) received normal saline 100 ㎖ and those in group I (instillation group) received intraperitoneal instillation of 2 ㎎/㎏ of ropivacaine diluted in 100 ㎖ saline at the initiation of pneumoperitoneum. Patients were assessed for pain by blinded investigators at 6 time intervals after surgery; 2 hr, 4 hr, 8 hr, 12 hr, 24 hr, and 48 hr. The frequency at which patients pushed the button of the PCA on bolus requirement (FPB) was assessed by a patient-controlled module on the PCA machine. Results: The mean total fentanyl consumption was lower in group I (367.39±85.88) than in group C (535±100.29) during the 48 hours (P＜0.001). Fentanyl velocity and FPB showed significant difference between the groups (P＜0.005). Visual analogue scale (VAS) measured pain scores were significantly lower in group I than in group C at 4 hr (P=0.027), 8 hr (P=0.010), 12 hr (P=0.011). Conclusion: Intraperitoneal instillation of ropivacaine at the beginning of laparoscopic cholecystectomy (LC) combined with normal saline infusion is an effective method for reducing pain after LC.

Efficacy of Periportal Infiltration and Intraperitoneal Instillation of Ropivacaine After Laparoscopic Surgery in Children

Postoperative pain is less intense after laparoscopic than after open surgery. However, minimally invasive surgery is not a a pain-free procedure. Many trials have been done in adults using intraperitoneal and/or incisional local anesthetic, but similar studies have not yet been reported in the literature in children. The aim of this study was to evaluate the analgesic effect of periportal infiltration and intraperitoneal instillation of ropivacaine in children undergoing laparoscopic surgery. Thirty patients who underwent laparoscopic surgery were randomly allocated to one of three groups. Group A (n = 10) received local infiltration of port sites with 10 mL of ropivacaine. Group B (n = 10) received both an infiltration of port sites with 10 mL of ropivacaine and an intraperitoneal instillation of 10 mL of ropivacaine. Group C did not receive any analgesic treatment. The local anesthetic was always administered at the end of surgery. The degree of postoperative abdominal parietal pain, abdominal visceral pain, and shoulder pain was assessed by using a Wong-Baker pain scale and a Visual Analog Scale (VAS) at 3, 6 12, and 24 hours postoperatively. The following parameters were also evaluated: rescue analgesic treatment, length of hospital stay, and time of return to normal activities. Three hours after operation, patients had low pain scores. Six and 12 hours postoperatively, the abdominal parietal pain was significantly higher (P < 0.0005) in group C than in the other two groups, both treated with an infiltration at the trocar sites; mean intensity of abdominal visceral pain was significantly lower (P < 0.0005) in group B than in groups A and C; the overall incidence of shoulder pain was significantly lower (P < 0.0005) in group B patients than in patients of groups A and C. At 20 hours postoperatively, pain scores were significantly reduced of intensity in all groups. Rescue analgesic treatment was significantly higher in group C, if compared to groups A and B 12 hours after the operation. No statistically significant difference was found in length of hospital stay, but children who received analgesic treatment had a more rapid return to normal activities than untreated patients (P < 0.0005). Our study demonstrates that the combination of local infiltration and intraperitoneal instillation of ropivacaine is more effective for pain relief in children after laparoscopic surgery than the administration of ropivacaine only at the trocar sites.

Repeated intraperitoneal instillation of levobupivacaine for the management of pain after laparoscopic cholecystectomy

Laparoscopic cholecystectomy is the treatment of choice for symptomatic cholelithiasis. Postoperative pain, however, can prolong hospital stay and lead to increased morbidity. In the context of a multimodal approach to analgesia, intraperitoneal local anesthetic administration optimizes analgesia and facilitates early postoperative recovery, and it may be associated with a decreased risk of side effects. A total of 71 patients was randomized to receive either intraperitoneal analgesic (IPA group) or not (controls). At the completion of cholecystectomy, 10 mL of levobupivacaine 0.5% were infused intraperitoneally in the IPA group and 8 h postoperatively, whereas in the controls, 10 mL of 0.9% NaCl were administered in the corresponding points of time. Differences in pain scores between groups were the primary endpoints. Opioid consumption and adverse effects were the secondary endpoints. The 2 groups were homogenous in respect to age, sex, body mass index (BMI), and duration of operation. No conversion, complication, or mortality was recorded. The IPA group had a lesser visual analog scale score at rest and at movement compared with controls at all points of time measured. Moreover, fentanyl consumption in the recovery room was significantly greater in the control group, and the consumption of meperidine and the percentage of the patients that requested rescue analgesia in the ward was significantly greater in the control group. Local analgesic intraperitoneal injection as well as parecoxib for postoperative analgesia had no significant adverse effects. Our study showed that 2 separate doses of intraperitoneally administered levobupivacaine significantly decreased postoperative pain and the need for opioids compared with placebo. This technique is simple, safe, and without adverse effects.

Effect of intra-abdominal instillation of lidocaine during minor laparoscopic procedures

Objective To assess the effect of intraperitoneal instillation of lidocaine on postoperative pain after minor gynecological laparoscopic surgery. Method A prospective, double-blind, placebo-controlled clinical trial of 75 patients undergoing gynecological laparoscopy randomized to receive intraperitoneal instillation of either 120 mg of lidocaine (n = 60) or normal saline (n = 15) at the end of surgery. Postoperative pain was evaluated by Wong-Baker Faces Pain Rating Scale (WBFS) score at 15 minutes and at 1, 2, 4, 12, and 24 hours postoperatively. Results The WBFS score was lower for the lidocaine group than for the control group at 1, 2, and 4 hours after surgery ( P = 0.023). There was no difference in WBFS scores between the 2 groups at 15 minutes ( P = 0.46), 12 hours ( P = 0.13), and 24 hours ( P = 0.07) after surgery. Conclusion Intraperitoneal instillation of lidocaine was effective in reducing postoperative pain after minor gynecological laparoscopic procedures.