Postoperative pain after laparoscopic and vaginal hysterectomy for benign gynecologic disease: a randomized trial

Fabio Ghezzi; Stefano Uccella; Antonella Cromi; Gabriele Siesto; Maurizio Serati; Giorgio Bogani; Pierfrancesco Bolis

doi:10.1016/j.ajog.2010.04.026

Postoperative pain after laparoscopic and vaginal hysterectomy for benign gynecologic disease: a randomized trial

Fabio Ghezzi, Stefano Uccella, Antonella Cromi, Gabriele Siesto, Maurizio Serati, Giorgio Bogani, Pierfrancesco Bolis

In: American Journal of Obstetrics and Gynecology · 2010 · vol. 203(2) , pp. 118.e1–118.e8 · doi:10.1016/j.ajog.2010.04.026 · PMID:20522410 · W2106484825

article OA: closed CC0 ⤵ 7 in-corpus citations

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This randomized trial compared postoperative pain levels in women undergoing laparoscopic versus vaginal hysterectomy for benign gynecologic disease.

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Abstract

ObjectiveTo compare postoperative pain after laparoscopic and vaginal hysterectomy for benign disease.Study designA prospective randomized trial was designed to compare laparoscopic hysterectomy and vaginal hysterectomy in patients with uterine volume <or=14 weeks of gestation. Postoperative pain was measured using the visual analog scale (VAS) at 1, 3, 8, and 24 hours postoperatively. Intra- and postoperative outcomes were carefully recorded, including the need for postoperative rescue doses of analgesia.ResultsA total of 82 patients were enrolled. Patients who underwent vaginal hysterectomy complained of higher postoperative pain at each VAS evaluation (VAS-1 hour, P < .0001; VAS-3 hour, P < .0001; VAS-8 hour, P < .0001; VAS-24 hour, P = .0003) with a higher need for rescue analgesia (P < .0001) and a longer hospitalization (P = .001). The other perioperative characteristics were comparable between the 2 groups.ConclusionLaparoscopic hysterectomy provides an advantage over vaginal hysterectomy in terms of postoperative pain, need for rescue analgesia and hospital stay, with similar perioperative outcomes.

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