Effect of presurgical local infiltration of levobupivacaine in the surgical field on postsurgical wound pain in laparoscopic gynecological surgery

Abstract

Background: To maintain a high standard of patient care, it is essential to provide adequate pain management in patients who undergo laparoscopic surgery.

Methods: We randomly enrolled 74 women who underwent laparoscopic surgery for gynecological benign diseases. Patients in the levobupivacaine group (n=37) were injected with 7 ml of 5 mg/ml levobupivacaine at all incisional areas patients in the control group (n=37) were injected with an equal volume of physiologic saline solution. In the postoperative period the following variables were assessed for each group: decline of hemoglobin concentration, consumption of analgesics, time of ambulation, length of postoperative ileus, length of postoperative hospital stay, and VAS scores at 6, 12, and 24 h after surgery.

Results: Mean pain intensity at 6 and 12 h after surgery was significantly lower in the levobupivacaine group than in the control group (p<0.01). Analgesic requirement was significantly lower (p<0.01) in the levobupivacaine group (0.3 phial+/-0.2) than in the control group (2.1 phial+/-1.0). The mean time of ambulation was significantly lower (p<0.05) in the levobupivacaine group (16+/-4) than in the control group (22+/-6). No significant difference was observed between the two groups in mean pain intensity 24 h after surgery, decline of hemoglobin concentration, length of postoperative ileus, or length of postoperative hospital stay.

Conclusions: Our results suggest that presurgical infiltration of levobupivacaine in addition to general anesthesia and standard analgesic therapy significantly decreases the intensity of postsurgical pain, especially for the first 12 h after surgery, and reduces analgesic consumption after surgery.