Clinical trial of analgesic effect of intraperitoneal Bupivacaine-Petidine infiltration compared with intravenous after diagnostic gynecologic laparpscopy

Recently most of laparoscopic surgeries especially gynecologic procedures are performed in an outpatient basis. Post operative pain is usually treated by opioids, which is expensive and may induce various side effects. Women experience moderate-to-severe pain on the first day after diagnostic laparoscopy. The aim of this study was to assess the efficacy of multimodal early premedication to prevent pain after laparoscopy. Following approval from the Local Ethics Committee and receipt of written informed consent, 90 ASA physical status I-II patients who underwent diagnostic laparoscopy will be randomly divided into two groups. General anesthesia will be standardized. The patients in group 1 will receive Paracetamol 1 g IV and intraperitoneal normal saline, 10 minutes before the end of operation. Group 2 will receive normal saline IV and intraperitoneal bupivacaine 0.25%, 40 ml with pethidine 50 mg, 10 minutes before the end of operation. The drugs will be prepared in covered syringes and will be injected blindly with an anesthesiologist who has performed anesthesia or with gynecologist(intraperitoneal drugs). Pain will be assessed and recorded by Visual Analogue Scale after arrival to the postanesthesia care unit and at 2, 4, 6, 8, 12 and 24 th hours postoperatively. Pethidine 0.5-1 mg/kg IV will be administered to the patient with VAS higher than 5. First analgesic request, total analgesia doses, and any other postoperative complications including nausea-vomiting and sedation also will be recorded.

Tabriz University of Medical Sciences