Title : Vaginal vault infiltration with bupivacaine for postoperative pain control after total laparoscopic hysterectomy: A randomized control trial
Abstract:
Objectives: To assess the effect of local infiltration of anaesthetic to the vaginal vault on post- operative pain after total laparoscopic hysterectomy.
Methods: A single centre, randomized trial. Women assigned to laparoscopic hysterectomy were randomly divided into two groups. In the intervention group (n=30) the vaginal cuff was infiltrated with 10ml of bupivacaine whereas the control group (n=30) did not receive local anaesthetic infiltration to vaginal vault. The primary outcome measure was to analyse the efficacy of bupivacaine infiltration in the study group by comparing the postoperative pain in both the groups at 1, 3, 6, 12, 24 hours using Visual analogue pain scale (VAS). Secondary outcome was to measure the need for rescue opioid analgesia.
Results: Group I (intervention group) has lesser mean VAS score at 1st, 3rd, 6th, 12th and 24 hours compared to Group II (control group). There was an additional requirement of opioid analgesia for postoperative pain in group II than in group I which is statistically significant (p<0.05).
Conclusion: Injection of local anaesthetic into the vaginal cuff, increased the number of women experiencing only minor pain after laparoscopic hysterectomy and decreased postoperative opioid usage and its side effects. Local anaesthesia of the vaginal cuff is safe and feasible.
