A Randomized Controlled Trial for Dual-Agent Local Analgesic in Sling Surgery

Area of Science:

• Urogynecology
• Surgical Pain Management

Background:

• Narcotic use is common after retropubic suburethral sling surgery.
• Topical analgesics are being explored to minimize postoperative opioid consumption.

Purpose of the Study:

• To evaluate if bupivacaine-meloxicam (Zynrelef) reduces narcotic use in the first 3 days post-retropubic sling surgery.
• To compare postoperative pain, satisfaction, and quality of recovery between Zynrelef and control groups.

Main Methods:

• A single-center, prospective, single-blinded randomized controlled trial was conducted.
• Women undergoing retropubic sling surgery received either Zynrelef or no topical analgesic.
• Pain, medication use, and quality of recovery were assessed over the first 3 postoperative days.

Main Results:

• No significant difference in total morphine milligram equivalents (MME) was observed between the Zynrelef group (30 MME) and the control group (37.5 MME) from postoperative days 0-3 (P = 0.61).
• Both groups reported low pain scores and high satisfaction with pain control.
• Quality of recovery scores were similar and improved by postoperative day 3.

Conclusions:

• Bupivacaine-meloxicam (Zynrelef) did not reduce narcotic use in the initial 3 days following retropubic sling surgery.
• Patients can expect low pain levels and quick recovery after this procedure, with minimal reliance on narcotics.