Preemptive port site local anesthesia in gynecologic laparoscopy: A randomized, controlled trial

STUDY OBJECTIVE: To assess the impact of preemptive infiltration of port site with local anesthetic on postlaparoscopy pain. DESIGN: Randomized, double-blind, controlled trial (Canadian Task Force classification 1). SETTING: Two university hospitals. PATIENTS: A total of 170 women scheduled for gynecologic laparoscopic procedures were randomly assigned to pre-incisional infiltration with ropivacaine (n = 86) or with saline solution (n = 84). INTERVENTIONS: Infiltration with either local anesthetic or placebo was accomplished in each port site before skin incision. All patients underwent standard anesthesia induction and maintenance. MEASUREMENTS AND MAIN RESULTS: Postoperative pain was evaluated with a Visual analogue scale and patient interview at 1, 3, and 24 hours after surgery. No difference was found between groups in pain levels, pain location, or in the site of superficial pain at any of the postoperative time periods. The proportion of women requiring analgesia before discharge was similar in the local anesthetic group and in the saline group (22/86 [25.6%] vs 19/84 [22.6%], p =.72). The analgesic consumption in the first 24 hours after surgery and the time to first analgesic request did not differ significantly between the two groups. CONCLUSION: Preemptive infiltration of trocar sites with ropivacaine is not effective in postoperative pain relief. (c) 2005 AAGL. All rights reserved.