Operative laparoscopy and postoperative pain relief.

OBJECTIVE

To evaluate the immediate postoperative pain and discomfort in patients who underwent operative laparoscopy under general anesthesia with or without peritoneal lidocaine and incisional bupivacaine instillations.

DESIGN

Fifty-four participants were prospectively randomized to three groups: group I, intraperitoneal (IP) lidocaine + intraincisional bupivacaine; group II, intraincisional bupivacaine; and group III, no additional drugs after general anesthesia (controls).

SETTING

University Hospital, Reproductive Endocrinology and Infertility Clinics.

PATIENTS

Private patients needing operative laparoscopy.

INTERVENTIONS

One hundred milligrams of lidocaine were instilled with the irrigation device into the peritoneal cavity at the completion of surgery. Twenty-five milligrams of bupivacaine were injected into infraumbilical and suprapubic incisions.

MAIN OUTCOME MEASURES

The analgesic use and modified McGill Present Pain Intensity scores were used for pain evaluation.

RESULTS

McGill Present Pain Intensity scores for pain, and narcotic use in the recovery room were less in IP lidocaine-instilled group of patients (P less than 0.05). The mean maximum plasma lidocaine level achieved was 1.01 +/- 0.25 micrograms/mL.

CONCLUSIONS

Peritoneal lidocaine and incisional bupivacaine use in operative laparoscopy as described after general anesthesia is safe and effective in reducing postoperative pain in the recovery room.