Efficacy of continuous wound infiltration of local anesthetic for pain relief after gynecologic laparoscopy

Abstract

OBJECTIVE: To assess the efficacy of analgesia provided by continuous ropivacaine

wound infiltration after gynecologic laparoscopy. METHODS: Sixty patients who

underwent gynecologic laparoscopy at Ajou University School of Medicine, Suwon,

Republic of Korea, between March and May 2012 were randomized to receive either

intravenous fentanyl and ketorolac infusion on demand by patient-controlled

analgesia (IV PCA group, n=31) or continuous wound infiltration of local

ropivacaine (CWI group, n=29). Postoperative pain and postoperative nausea and

vomiting (PONV) were assessed via a visual analog scale. The number of patients

who requested rescue analgesia was recorded. RESULTS: There was no significant

difference in postoperative pain between the 2 groups, but more patients

requested rescue analgesia in the CWI group than in the IV PCA group in 24 hours

(18 versus 9 patients, respectively; P=0.010). The PONV scores at 12 and 24 hours

were, respectively, 0.28 and 0.27 in the CWI group, and 0.71 and 0.73 in the IV

PCA group (P=0.004). Nine patients requested cessation of IV PCA because of

severe nausea or vomiting. CONCLUSION: Continuous ropivacaine wound infiltration

was found to be as effective as patient-controlled analgesia for postoperative

pain relief after gynecologic laparoscopy. This technique provides good analgesia

with less opioid analgesic requirement and few adverse effects.