Seo Jong Wook, Lee In Ok, Kim Jung Cheol, Chung Jae Eun
Department of Obstetrics and Gynecology,National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Department of Obstetrics and Gynecology,Yonsei University, Severance Hospital, Seoul, Korea.
Obstet Gynecol Sci. 2020 May;63(3):387-394. doi: 10.5468/ogs.2020.63.3.387. Epub 2020 Apr 7.
To investigate the role of port-site bupivacaine hydrochloride injection in laparoendoscopic single-site surgery (LESS) as a means of postoperative umbilical pain alleviation.
A total of 200 consecutive patients who underwent LESS from October 2018 to February 2019 were included in this randomized 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 same operational setting by 3 board-certified gynecologists. Postoperative umbilical pain scores assessed using the visual analog scale were compared between the 2 groups as the primary outcome. Student's -test, χ test, and a linear mixed model were used for the statistical analysis. A -value of <0.05 was considered to be statistically significant.
The patients' age, body mass index, and menopausal status; type of surgery performed; and need for additional trocar insertion exhibited a significant difference between the bupivacaine injection and non-injection groups. After adjusting for various confounding variables, the postoperative umbilical pain scores measured at postoperative 2-3 hours, 6-10 hours, 1 day, and 3 days did not exhibit a significant difference between the 2 groups.
Port-site bupivacaine injection in LESS did not show any additive effect in alleviation of postoperative umbilical pain.
探讨术口注射盐酸布比卡因在腹腔镜单孔手术（LESS）中作为减轻术后脐部疼痛手段的作用。
本随机前瞻性病例对照研究纳入了2018年10月至2019年2月期间连续接受LESS手术的200例患者。患者被交替分配至研究组（术后在脐部1.5 cm切口处注射10 mL 0.25%盐酸布比卡因）或对照组（不注射）。所有患者均在韩国峨山医院由3名获得认证的妇科医生在相同手术条件下进行手术。以视觉模拟量表评估的术后脐部疼痛评分作为主要结局指标，在两组间进行比较。采用学生t检验、χ检验和线性混合模型进行统计分析。P值<0.05被认为具有统计学意义。
布比卡因注射组和非注射组患者的年龄、体重指数、绝经状态、手术类型以及是否需要额外插入套管针方面存在显著差异。在调整各种混杂变量后，术后2 - 3小时、6 - 10小时、1天和3天测得的术后脐部疼痛评分在两组间无显著差异。
LESS术中术口注射布比卡因在减轻术后脐部疼痛方面未显示出任何附加效果。
