The role of port site local anesthetic injection in laparoendoscopic single site surgery: a prospective randomized study
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ObjectiveTo investigate the role of port-site bupivacaine hydrochloride injection in laparoendoscopic single-site surgery (LESS)as a means of postoperative umbilical pain alleviation. MethodsA total of 200 consecutive patients who underwent LESS from October 2018 to February 2019 were included in thisrandomized prospective case control study. The patients were alternatively assigned to either the study group (0.25%10-mL bupivacaine hydrochloride injection at the 1.5-cm umbilical incision site after surgery) or the control group(no injection). All patients underwent surgery at the National Health Insurance Service Ilsan Hospital under the sameoperational setting by 3 board-certified gynecologists. Postoperative umbilical pain scores assessed using the visualanalog scale were compared between the 2 groups as the primary outcome. Student’s t-test, χ2 test, and a linearmixed model were used for the statistical analysis. A P-value of <0.05 was considered to be statistically significant. ResultsThe patients’ age, body mass index, and menopausal status; type of surgery performed; and need for additionaltrocar insertion exhibited a significant difference between the bupivacaine injection and non-injection groups. Afteradjusting for various confounding variables, the postoperative umbilical pain scores measured at postoperative2–3 hours, 6–10 hours, 1 day, and 3 days did not exhibit a significant difference between the 2 groups. ConclusionPort-site bupivacaine injection in LESS did not show any additive effect in alleviation of postoperative umbilical pain.
Abstract
ObjectiveTo investigate the role of port-site bupivacaine hydrochloride injection in laparoendoscopic single-site surgery (LESS)as a means of postoperative umbilical pain alleviation. MethodsA total of 200 consecutive patients who underwent LESS from October 2018 to February 2019 were included in thisrandomized prospective case control study. The patients were alternatively assigned to either the study group (0.25%10-mL bupivacaine hydrochloride injection at the 1.5-cm umbilical incision site after surgery) or the control group(no injection). All patients underwent surgery at the National Health Insurance Service Ilsan Hospital under the sameoperational setting by 3 board-certified gynecologists. Postoperative umbilical pain scores assessed using the visualanalog scale were compared between the 2 groups as the primary outcome. Student’s t-test, χ2 test, and a linearmixed model were used for the statistical analysis. A P-value of <0.05 was considered to be statistically significant. ResultsThe patients’ age, body mass index, and menopausal status; type of surgery performed; and need for additionaltrocar insertion exhibited a significant difference between the bupivacaine injection and non-injection groups. Afteradjusting for various confounding variables, the postoperative umbilical pain scores measured at postoperative2–3 hours, 6–10 hours, 1 day, and 3 days did not exhibit a significant difference between the 2 groups. ConclusionPort-site bupivacaine injection in LESS did not show any additive effect in alleviation of postoperative umbilical pain.
참고문헌 (25)
- Khavanin N, "Comparison of perioperative outcomes in outpatient and inpatient laparoscopic hysterectomy", J Minim Invasive Gynecol, 20, pp.604~610 (2013)
- Wattiez A, "Laparoscopic hysterectomy", Curr Opin Obstet Gynecol, 14, pp.417~422 (2002)
- Pitter MC, "The impact of different surgical modalities for hysterectomy on satisfaction and patient reported outcomes", Interact J Med Res, 3, pp.e11~ (2014)
- Medeiros LR, "Laparoscopy versus laparotomy for benign ovarian tumour", Cochrane Database Syst Rev, pp.CD004751~ (2009)
- Marks JL, "Systematic review and metaanalysis of intraperitoneal instillation of local anesthetics for reduction of pain after gynecologic laparoscopy", J Minim Invasive Gynecol, 19, pp.545~553 (2012)
- Parsanezhad ME, "Comparative, double-blind, randomized, placebo-controlled trial of intraperitoneal of bupivacaine and lidocaine for pain control after diagnostic laparoscopy", J Am Assoc Gynecol Laparosc, 10, pp.311~315 (2003)
- Saleh A, "Effects of local bupivacaine instillation on pain after laparoscopy", J Am Assoc Gynecol Laparosc, 8, pp.203~206 (2001)
- Lam KW, "Efficacy of preemptive analgesia for wound pain after laparoscopic operations in infertile women : a randomised, double-blind and placebo control study", BJOG, 111, pp.340~344 (2004)
- Roy KK, "Intraperitoneal bupivacaine for pain relief after minilaparoscopy in patients with infertility", Arch Gynecol Obstet, 289, pp.337~340 (2014)
- Ghezzi F, "Preemptive port site local anesthesia in gynecologic laparoscopy : a randomized, controlled trial", J Minim Invasive Gynecol, 12, pp.210~215 (2005)
- Savaris RF, "Does bupivacaine in laparoscopic ports reduce postsurgery pain in tubal ligation by electrocoagulation? A randomized controlled trial", Contraception, 81, pp.542~546 (2010)
- Tam T, "Infiltration of bupivacaine local anesthetic to trocar insertion sites after laparoscopy : a randomized, double-blind, stratified, and controlled trial", J Minim Invasive Gynecol, 21, pp.1015~1021 (2014)
- 김정은, "Port site infiltration of local anesthetic after laparoendoscopic single site surgery for benign adnexal disease", Obstetrics & Gynecology Science, 60(5), pp.455~461 (2017), 대한산부인과학회[DOI]
- Lee YY, "Single port access laparoscopic adnexal surgery versus conventional laparoscopic adnexal surgery : a comparison of peri-operative outcomes", Eur J Obstet Gynecol Reprod Biol, 151, pp.181~184 (2010)
- Hoyer-Sørensen C, "Is single-port laparoscopy for benign adnexal disease less painful than conventional laparoscopy? A single-center randomized controlled trial", Fertil Steril, 98, pp.973~979 (2012)
- Teoh AY, "A double-blinded randomized controlled trial of laparoendoscopic single-site access versus conventional 3-port appendectomy", Ann Surg, 256, pp.909~914 (2012)
- Sangnier E, "Single port laparoscopy(SPL) : retrospective study evaluating postoperative pain in comparison with conventional laparoscopy(CL)", J Gynecol Obstet Hum Reprod, 47, pp.365~369 (2018)
- Fagotti A, "Postoperative pain after conventional laparoscopy and laparoendoscopic single site surgery(LESS)for benign adnexal disease : a randomized trial", Fertil Steril, 96, pp.255~9.e2 (2011)
- Mencaglia L, "Single port entry-Are there any advantages?", Best Pract Res Clin Obstet Gynaecol, 27, pp.441~455 (2013)
- Fader AN, "Laparoendoscopic single-site surgery(LESS)in gynecology : a multi-institutional evaluation", Am J Obstet Gynecol, 203, pp.501.e1~6 (2010)
- Figurelli J, "Single-port access laparoscopic surgery in gynecologic oncology : outcomes and feasibility", Int J Gynecol Cancer, 24, pp.1126~1132 (2014)
- Balasanmugam C, "Bradycardia, hypotension, and cardiac arrest : a complication of local anesthetics", Cureus, 11, pp.e4033~ (2019)
- Beiranvand S, "Bupivacaine versus liposomal bupivacaine for pain control", Drug Res(Stuttg), 68, pp.365~369 (2018)
- Yan Z, "Liposomal bupivacaine versus interscalene nerve block for pain control after shoulder arthroplasty: a meta-analysis", Medicine(Baltimore), 96, pp.e7226~ (2017)
- Sun H, "Do liposomal bupivacaine infiltration and interscalene nerve block provide similar pain relief after total shoulder arthroplasty : a systematic review and meta-analysis", J Pain Res, 11, pp.1889~1900 (2018)
