A prospective, randomized, double-blind, placebo-controlled trial of multimodal intraoperative analgesia for laparoscopic excision of endometriosis

Michael F Costello, Michael Costello, Abbott J, Jason Abbott, Steven G. Katz, Katz S, Steven Katz, Thierry G. Vancaillie, Thierry Vancaillie, Vancaillie T, Wilson S, Sally Wilson
Fertility and sterility · 2009 · vol. 94(2) , pp. 436–443 · doi:10.1016/j.fertnstert.2009.03.025 · PMID:19394603 · W2136731154
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This prospective, randomized, double-blind trial investigated the efficacy of multimodal intraoperative analgesia compared to placebo for laparoscopic endometriosis excision.

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Abstract

ObjectiveTo assess the efficacy of multimodal intraoperative analgesia in reducing postoperative pain and/or opioid requirements in women undergoing laparoscopic excision of endometriosis.DesignProspective, randomized, double-blind, placebo-controlled trial.SettingEndogynecologic department of a university teaching hospital.Patient(s)Women booked for laparoscopic excision of endometriosis.Intervention(s)Intraoperative multimodal analgesia versus placebo. Analgesia consisted of Diclofenac sodium 100 mg suppository per rectum and 0.75% Ropivacaine to portal sites, subperitoneally under excision sites and topically to each subdiaphragmatic area.Main outcome measure(s)Postoperative total hospital opioid analgesic requirements and postoperative pain intensity.Result(s)The study was terminated prematurely, after a planned interim analysis (which included 66 randomized patients or 43% of the planned number of patients) found significantly less total hospital opioid requirements in the analgesic group compared with the placebo group (19.0 mg vs. 34.5 mg; difference -14.0 mg [95% confidence interval -26.0 to -2.0 mg]). There was no difference in postoperative pain intensity between the two groups.Conclusion(s)The use of multimodal intraoperative analgesia at laparoscopic excision of endometriosis reduces postoperative opioid requirements.

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Condition tags

endometriosis

MeSH descriptors

Amides Anesthetics, Local Diclofenac Endometriosis Intraoperative Care Laparoscopy Adolescent Adult Amides Analgesia Analgesia Analgesics, Opioid Analgesics, Opioid Anesthetics, Local Anti-Inflammatory Agents, Non-Steroidal Anti-Inflammatory Agents, Non-Steroidal Diclofenac Double-Blind Method Endometriosis Female

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