Systematic Review and Metaanalysis of Intraperitoneal Instillation of Local Anesthetics for Reduction of Pain After Gynecologic Laparoscopy

Jennifer Marks, Barış Ata, Togas Tulandi
In: Journal of Minimally Invasive Gynecology · 2012 · vol. 19(5) , pp. 545–553 · doi:10.1016/j.jmig.2012.04.002 · PMID:22763313 · W2141654933
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This systematic review and meta-analysis evaluated the effectiveness of intraperitoneal local anesthetic instillation in reducing post-gynecologic laparoscopy pain.

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Abstract

We reviewed the effectiveness of intraperitoneal instillation of local anesthetic on pain after gynecologic laparoscopic surgery. Sources included the Cochrane Central Register of Controlled Trials, MEDLINE/PubMed, EMBASE, and Ovid MEDLINE In-Process & Other Non-Indexed Citations databases, and abstracts, reference lists, and randomized controlled trial (RCT) registries. The 7 included RCTs compared pain scores after administration of intraperitoneal analgesics or placebo/control during gynecologic laparoscopic surgery with benign indications. Outcome measures were pain scores (per visual analog scale) at 1 to 2, 4 to 6, and 24 hours postoperatively. Pain scores were significantly lower in the groups receiving local anesthesia at 1 to 2 hours (weighted mean difference [WMD], -1.82; 95% confidence interval [CI], -2.55 to -1.08]) and 4 to 6 hours postoperatively (WMD, -2.00; 95% CI, -3.64 to -0.35), but were similar at 24 hours (WMD, -1.43; 95% CI, -1.15 to 0.96). Local analgesia instilled intraperitoneally significantly decreased pain during a 6-hour interval after gynecologic laparoscopy.

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