Clinical evaluation of intraperitoneal bupivacaine, or combined with morphine and pethidine for analgesia after laparoscopic gynecologic procedures

ABSTRACT

Pain after laparoscopic gynecology is an important factor that increases hospital admission after day-case laparoscopy. The study compared the postoperative analgesic effect of intraperitoneal instillation of bupivacaine, bupivacine + pethidine, bupivacaine + morphine and saline in 48 patients after laparoscopic gynecologic procedures. Each group had 12 patients. The study showed that in the pethidine added group, the duration of analgesia was longest with the lowest VAS scores and the least side-effects. Adding morphine to bupivacaine added no clinically additional analgesic advantage, however, it increased the incidence of side-effects. The study concluded that intraperitoneal instillation of 20 ml. of 0.5% bupivacaine + 100 mg. pethidine after laparoscopic gynecologic procedures proved simple, safe, effective technique with minimal side-effects and is recommended to be applied at the designated sites at the end of gynecologic laparoscopy