Abstract | STUDY OBJECTIVE: DESIGN: Double-blind randomized controlled trial (Canadian Task Force classification I). SETTING: University-affiliated hospital. PATIENTS: Women aged between 18 and 65 years scheduled to undergo total laparoscopic hysterectomy for benign indications. INTERVENTIONS: Eligible patients were allocated to control or treatment groups using block randomization. Surgeon administered injection of either .9% NaCl or .5% bupivacaine into the cervical stroma at the 3 and 9 o'clock positions after general anesthesia was established. Pain was assessed using a visual analog scale with a range from 0 to 10 at 30 and 60 minutes after extubation. MEASUREMENTS AND MAIN RESULTS: Forty-one patients met criteria for analysis. Based on randomization, 20 were allocated to the control arm and 21 to the treatment arm. We used Student t and Pearson χ2 tests to ensure both groups were homogenous to age (46.5 vs 46, p = .87), body mass index (35 vs 32.7 kg/m2, p = .45), minutes of operating time (132.5 vs 119.7, p = .11), specimen weight (138.8 vs 160.6 g, p = .44), and history of cesarean section (p = .58). Pain scores at 30 minutes (5.7 vs 3.2, p = .01) and 60 minutes (5.9 vs 2.3, p <.001) were significantly lower in the treatment arm. We dichotomized results depending on whether patients had successful postoperative pain control, defined as an average pain score of 4 or less. The χ2 test was used for comparison. Using this definition 25% of patients had successful pain control in the placebo group versus 71.4% in the treatment group. This was statistically significant (p = .003). Mean length of hospital stay (.65 vs .86 days, p = .44) was not statistically different. CONCLUSION:
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Authors | Steven Radtke, Todd Boren, Stephen Depasquale |
Journal | Journal of minimally invasive gynecology
(J Minim Invasive Gynecol)
2019 Sep - Oct
Vol. 26
Issue 6
Pg. 1164-1168
ISSN: 1553-4669 [Electronic] United States |
PMID | 30528725
(Publication Type: Journal Article, Randomized Controlled Trial)
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Copyright | Copyright © 2019. Published by Elsevier Inc. |
Chemical References |
- Anesthetics, Local
- Bupivacaine
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Topics |
- Adolescent
- Adult
- Aged
- Anesthesia, General
- Anesthesia, Obstetrical
(methods)
- Anesthetics, Local
(administration & dosage, adverse effects)
- Bupivacaine
(administration & dosage, adverse effects)
- Double-Blind Method
- Female
- Humans
- Hysterectomy
(adverse effects, methods)
- Laparoscopy
(adverse effects, methods)
- Length of Stay
- Middle Aged
- Operative Time
- Pain Management
(methods)
- Pain Measurement
- Pain, Postoperative
(etiology, prevention & control)
- Preoperative Care
(methods)
- Uterine Diseases
(surgery)
- Young Adult
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