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Randomized controlled trial investigating the effect of transcervical papaverine and bupivacaine on postoperative analgesia following laparoscopic sterilization

Published online by Cambridge University Press:  16 August 2006

A. Ng
Affiliation:
Leicester Royal Infirmary, University Department of Anaesthesia, Critical Care & Pain Management, UK
A. Habib
Affiliation:
Leicester Royal Infirmary, University Department of Anaesthesia, Critical Care & Pain Management, UK
A. Swami
Affiliation:
Leicester Royal Infirmary, University Department of Anaesthesia, Critical Care & Pain Management, UK
G. Smith
Affiliation:
Leicester Royal Infirmary, University Department of Anaesthesia, Critical Care & Pain Management, UK
D. Nunns
Affiliation:
Leicester Royal Infirmary, Department of Obstetrics and Gynaecology, Leicester, UK
A. C. Davidson
Affiliation:
Leicester Royal Infirmary, Department of Obstetrics and Gynaecology, Leicester, UK
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Abstract

Background and objective: A critical factor that delays patient discharge following day-surgery is severe postoperative pain and the requirement for strong analgesics. Laparoscopic sterilization is a day case procedure and is associated with additional postoperative pain compared with diagnostic laparoscopy. This pain, associated with application of Filshie clips, may be ischaemic or spasmodic in aetiology. Papaverine relaxes smooth muscle, and the aim of the study was to investigate if papaverine would be effective in improving postoperative pain if administered directly to the Fallopian tubes. Bupivacaine is used commonly in day-surgery and so we compared the effect of this local anaesthetic with saline placebo.

Methods: Sixty-six ASA I-II females undergoing laparoscopic sterilization were entered into the prospective, randomized, double-blind, placebo-controlled clinical trial. They received intrauterine papaverine (30 mg) or bupivacaine (0.375% 30 mL) or normal saline (30 mL) via the transcervical route before application of Filshie clips.

Results: There were no significant differences in the postoperative period between the three groups in the number of patients needing analgesia in the first 60 min postoperatively, the time to first analgesia, the rescue analgesic or antiemetic consumption, the incidence of postoperative nausea and vomiting, and the sedation and visual analogue pain scores.

Conclusions: From the data presented, we would not recommend routine transcervical administration of papaverine or bupivacaine for pain following laparoscopic sterilization.

Type
Original Article
Copyright
2002 European Society of Anaesthesiology

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