Topical bupivacaine and etidocaine analgesia following fallopian tube banding.

The purpose of this study was to compare the effectiveness and safety of etidocaine and bupivacaine for postoperative analgesia after laparoscope sterilization. The study was performed in 22 healthy patients who received either one per cent etidocaine, 2 mg.kg-1, or bupivacaine 1.5 mg.kg-1 in a double-blind, randomized fashion. The local anaesthetic was dropped onto the fallopian tubes from uterus to fimbriae before tubal occlusion. To establish safety, blood concentrations of the parent drug and its metabolites were measured before application and at 1, 3, 6, 10, 15, 30, 60 and 120 min. The mean peak concentrations were 501.8 +/- 71.3 (SEM) for etidocaine with a range of 225 to 905 ng.ml-1. For bupivacaine, the mean peak concentration was 468 +/- 73.8 SEM with a range from 191 to 1005 ng.ml-1. The mean values are one eighth of the toxic convulsive dose for humans. Etidocaine was metabolized at a faster rate than bupivacaine with a rapid appearance of 2-amino-2'-butyroxylidide (ABX). The bupivacaine metabolite 2,6-pipecoloxylidide (PPX) was detected in low concentrations in the 60-minute samples. We conclude that the topical application of either etidocaine or bupivacaine is a safe procedure in the doses and concentrations used during general anaesthesia for laparoscopic tubal banding.

Comparison of continuous sufentanil and fentanyl infusions for outpatient anaesthesia.

Fifty ASA physical status class I or II patients undergoing outpatient D & C (dilatation and curettage of the uterus) were studied. Patients were divided into two groups in a random double-blind manner and given either a fentanyl bolus 0.7 microgram X kg-1 followed by continuous fentanyl infusion of 0-50 micrograms X min-1 or sufentanil bolus 0.1 microgram X kg-1 followed by continuous sufentanil infusion of 0-7 micrograms X min-1 as an adjuvant to thiopentone, nitrous oxide: oxygen anaesthesia. Patients were followed throughout the recovery process with respect to level of consciousness, nausea, vomiting, pain, and discharge time. Groups were equal with respect to awakening and discharge time. The incidence of nausea (p less than 0.05) and pain requiring analgesics (p less than 0.05) were less in the sufentanil group. It is concluded that the technique of continuous sufentanil infusion was superior to fentanyl in healthy outpatients undergoing D & C.

Topical etidocaine during laparoscopic tubal occlusion for postoperative pain relief.

Narcotic requirements in 51 day-surgery patients following laparoscopic tubal occlusion were significantly reduced (P less than .01) by the use of 1% etidocaine 5 mL, dropped on each fallopian tube from uterus to fimbrias before tubal banding when compared with a control group of 51 day-surgery patients who had no topical anesthetic agent. All patients received general anesthesia. Although there was no significant difference in nausea rate, the incidence of vomiting was decreased. Eight of 51 patients (16%) having topical etidocaine and 19 of 51 (37%) who had no etidocaine vomited during the postoperative period. The frequency of overnight stay was significantly reduced in the topical etidocaine group of patients (P less than or equal to .01).