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

OBJECTIVE: To assess the efficacy of multimodal intraoperative analgesia in reducing postoperative pain and/or opioid requirements in women undergoing laparoscopic excision of endometriosis. DESIGN: Prospective, randomized, double-blind, placebo-controlled trial. SETTING: Endogynecologic 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 Laparoscopy Adolescent Adolescent Adult Adult Amides Amides Analgesia Analgesia Analgesia Analgesics, Opioid Analgesics, Opioid Analgesics, Opioid Anesthetics, Local

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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