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Local infiltration analgesia in urogenital prolapse surgery: a prospective randomized, double-blind,
Billy B Kristensen1, Yvonne H Rasmussen, Marianne Agerlin
1Department of Anesthesiology, Hvidovre University Hospital, Kettegård Allé 30, Copenhagen, Denmark. billy.kristensen@hvh.regionh.dk
Objective:
To evaluate the analgesic effect of high-volume infiltration analgesia in urogenital prolapse surgery and provide a detailed description of the infiltration technique.
Design:
A randomized, double-blind, placebo-controlled study following the CONSORT criteria.
Setting:
A university hospital.
Patients:
48 patients undergoing posterior wall repair and perineorraphy.
Methods:
Patients received high-volume (26 ml) ropivacaine 1% with epinephrine (n=23) or saline (n=22) infiltration using a systematic technique ensuring uniform delivery to all tissues incised, handled or instrumented during the procedure.
Main Outcome Measures:
Pain and opioid requirements were assessed for 24 hours as well as time spent in the post-anesthesia care unit and time to first mobilization.
Results:
Pain at rest, during coughing and movement was significantly reduced for the first four hours with the high-volume local anesthetic infiltration technique (p<0.001-0.006). Opioid requirements and time spent in the post-anesthesia care unit were significantly reduced in the ropivacaine group (p<0.001 and p<0.001, respectively) as well as the time to first mobilization (p<0.014).
Conclusion:
Systematic high-volume infiltration analgesia is an effective analgesic technique in patients undergoing posterior wall repair and perineorraphy, and improves early recovery.
