Intraoperative topical etidocaine for reducing postoperative pain after laparoscopic tubal ligation.

ABSTRACT

PIP: The results of a randomized, double-blind, clinical trial suggest that topical etidocaine can significantly reduce postoperative pain when applied to the fallopian tubes after tubal banding. The 97 study subjects were woman admitted to a New York clinic in 1985-87 for same- day laparoscopic tubal ligation with Falope rings. All patients received general anesthesia and underwent the standard 2-puncture laparoscopic technique. In the 46 cases, 5 mL of 1% etidocaine was applied to the banded portion of each fallopian tube after ligation. In the 41 controls, normal saline was administered to the tubes. Patients were asked to rate their postoperative pain on a scale from 0 (no pain)- 10 (worse pain ever experienced) at 3 intervals: 2 hours after return from the recovery room, at the time of hospital discharge, and 24 hours after discharge. Mean analog pain scores were significantly lower in the etidocaine group than the placebo group after return from the recovery room and the time of discharge (p0.05); there was no significant differences between the 2 groups 24 hours after discharge in terms of pain level. Women who received etidocaine also required less medication for postoperative nausea and vomiting (24%) than controls (37%), but this difference was not significant. Finally, a smaller percentage of women from the etidocaine group required parenteral or oral analgesics postoperatively (74% compared with 95% of the controls). Application of etidocaine to the banded tubes took only 2-3 minutes and was easily learned by the operating gynecologists.