Vaginal Cuff Infiltration with a Local Anesthetic for Postoperative Pain after Laparoscopic Hysterectomy: A Randomized Control Trial

Olga Kilpio, Paivi SM Harkki, Maarit J Mentula and Paivi I Pakarinen

Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Finland

^*Correspondance to: Olga Kilpio 

 PDF  Full Text DOI: 10.25107/2474-1647.2489

Abstract

Objectives: To assess the effect of local infiltration of anesthetic to the vaginal cuff on postoperative pain after laparoscopic hysterectomy. Methods: A single-center, randomized trial. Women assigned to laparoscopic hysterectomy were randomly divided into two groups. In the intervention group (n=41) the vaginal cuff was infiltrated with 10 ml of ropivacaine (7.5 mg/ml) at four points, in addition to trocar-site anesthesia. In the control group (n=40) only trocar incisions were infiltrated with local anesthetic. The primary outcomes were postoperative opioid (oxycodone) use and postoperative pain in Visual Analog Scale (VAS). Secondary outcomes were emesis, bleeding, operative time, time to discharge and complications. Results: The number of patients with minimal pain i.e. VAS scores for pain below 3 was significantly higher in the intervention group than in the control group (17 vs. 8, p=0.04). Otherwise, there were no significant differences between the groups in VAS scores for pain, the use of opioids or in any other variables. Conclusion: Injection of local anesthetic into the vaginal cuff along with trocar sites analgesia did not affect the use of oxycodone, but increased the number of women experiencing only minor pain after laparoscopic hysterectomy. Local anesthesia of the vaginal cuff was feasible and safe.

Keywords

Laparoscopy; Hysterectomy; Local analgesia; Vaginal wound; Postoperative pain

Cite the article

Kilpio O, Harkki PSM, Mentula MJ, Pakarinen PI. Vaginal Cuff Infiltration with a Local Anesthetic for Postoperative Pain after Laparoscopic Hysterectomy: A Randomized Control Trial. Clin Surg. 2019; 4: 2489.