Effect of Vaginal Cuff Infiltration with Bupivacaine on Postoperative Pain after Vaginal Hysterectomy: A Randomized...

To evaluate the effect of vaginal cuff infiltration with bupivacaine on postoperative pain and early recovery parameters after vaginal hysterectomy.

Prospective, randomized, controlled clinical trial.

Department of Obstetrics and Gynecology, Gaziosmanpaşa Training and Research Hospital, Istanbul, Türkiye.

Forty-eight women undergoing vaginal hysterectomy for benign indications were included and randomized into 2 groups: bupivacaine infiltration group (n = 24) and control group (n = 24).

Patients were randomized into 2 groups using computer-generated randomization. In the intervention group, 10 mL of 0.25% bupivacaine was bilaterally infiltrated into the vaginal cuff, whereas no local anesthetic was applied in the control group.

Postoperative pain was assessed using the visual analog scale at 1, 3, 6, 12, and 24 hours. In addition to pain scores, recovery parameters including time to mobilization, time to first flatus, length of hospital stay, and additional analgesic requirement were recorded. Visual analog scale scores were significantly lower in the bupivacaine group at all time points (p <.05). Furthermore, patients in the intervention group required fewer additional analgesics (p <.001), mobilized earlier (p <.001), and had a shorter hospital stay (p = .0009).

Vaginal cuff infiltration with bupivacaine is an effective and safe method for reducing postoperative pain. Beyond pain control, this approach seems to facilitate early postoperative recovery and may contribute to multimodal analgesia strategies.