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Bupivacaine injection during midurethral sling and postoperative pain: a randomized controlled trial
Gena C Dunivan1, Brent A Parnell, AnnaMarie Connolly
1Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, 3032 Old Clinic Building, Campus Box 7570, Chapel Hill, NC 27599-7570, USA.
Introduction And Hypothesis:
The aim of this study was to investigate the impact of retropubic injection of 0.125% bupivacaine during midurethral sling placement on postoperative pain.
Methods:
A randomized, double-blind trial of 42 women undergoing midurethral sling for stress incontinence was conducted. The intervention group received an injection of 0.125% bupivacaine in the retropubic space prior to midurethral sling placement, while the control group received no injection. Pain scores were recorded via a 10-cm visual analog scale at 2, 6, and 24 h postoperatively.
Results:
Pain scores were lower in the bupivacaine group compared to the control group at 2 h (1.9 versus 2.6, p = 0.05). Mean pain scores were similar at all other time points (all p > 0.45). Participants in both groups used similar amounts of pain medication in the hospital, except that patients in the bupivacaine group used more PO non-steroidal anti-inflammatory drugs (p = 0.047).
Conclusions:
Retropubic injection of 0.125% bupivacaine at the time of midurethral sling placement decreases short-term postoperative pain.
