Pain relief following day case laparoscopic tubal ligation with intra‐peritoneal ropivacaine: a randomised double blind control study

Abstract

The aim of this study was to examine the effectiveness of ropivacaine administered by a simple intraperitoneal technique in relieving pain following laparoscopic application of Filshie clips. Nineteen patients were randomised to receive either ropivacaine (200 mg) or normal saline through the umbilical port following clip application. Using a visual analogue scale women receiving ropivacaine had significantly lower pain scores 2 hours post operatively (0.97 vs 2.03 p < 0.05). The mean total postoperative fentanyl use was also significantly lower on the ropivacaine group (40 microg vs 104 microg p < 0.02). Only 10% (1/10) of the women in the ropivacaine group complained of nausea compared with 44% (4/9) in the control group. Furthermore, 80% (8/10) of women in the ropivacaine group were either very or totally satisfied with their pain relief. Only 56% (5/9) of the women in the control group were very or totally satisfied with their pain relief. Ropivacaine administered by a simple intraperitoneal technique following laparoscopic sterilisation significantly reduces postoperative pain and parenteral analgesic requirements. It would be reasonable to consider this method as standard practice following laparoscopic tubal ligation.

Reducing Postoperative Pain After Tubal Ligation With Rings or Clips

“…Seven studies 8,11,15,18,20,22,25 reported their results only in figures. To include these results in the metaanalysis, two authors (M.N.D., M.S.H.)…”

“…Seven studies 18,[20][21][22][23][24]26 reported results only as medians, and 13 [8][9][10][11][12][13][14][15][16][17]19,25,27 reported results as means. For the purposes of the meta-analysis, we included all studies (means and medians), but we also examined them separately.…”

“…We subsequently excluded one paper as a result of our inability to calculate a variance estimate, 7 leaving 20 papers for the analysis (Table 1). [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Only one author 10 provided useful additional information (regarding the timing of pain measurements).…”

“…We mapped pain scores from each study onto these six time points. When studies reported pain scores at an event rather than at a time, we assigned the pain score to the nearest time point as follows: arrival to the postanesthesia care unit: 30 minutes postextubation 14,18,25 ; discharge: 8 hours postextubation 11,14,[16][17][18][19]21,23,25,27 except where specified to be earlier 12 ; and postoperative day 1: 24 hours postextubation. 12,25,27 For studies that reported multiple pain scores, we used only the six that were closest to the times we defined and excluded additional pain scores.…”

Ropivacain after inguinal hernia surgery

“…Neue re An wen dungs be rei che sind intra ka vi täre In stil la tio nen der Lo kal an äs-the ti ka, wie sie bei spiels wei se bei der Arthro sko pie [22] oder der La pa ro sko pie [7,21] durch ge führt wer den. Auch hier hat sich Ro pi va cain mit sei ner gro ßen the rapeu ti schen Brei te durch ge setzt.…”