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Port site infiltration of local anesthetic after laparoendoscopic single site surgery for benign adnexal disease

대한산부인과학회지 2017년 60권 5호 p.455 ~ 461
 ( Kim Jung-Eun ) - Konkuk University School of Medicine Department of Obstetrics and Gynecology

 ( Shim Seung-Hyuk ) - Konkuk University School of Medicine Department of Obstetrics and Gynecology
 ( Dong Me-A-Ri ) - Konkuk University School of Medicine Department of Obstetrics and Gynecology
 ( Lee Hyo-Jin ) - Konkuk University School of Medicine Department of Obstetrics and Gynecology
 ( Hwang Han-Sung ) - Konkuk University School of Medicine Department of Obstetrics and Gynecology
 ( Kwon Han-Sung ) - Konkuk University School of Medicine Department of Obstetrics and Gynecology
 ( Lee Sun-Joo ) - Konkuk University School of Medicine Department of Obstetrics and Gynecology
 ( Lee Ji-Young ) - Konkuk University School of Medicine Department of Obstetrics and Gynecology
 ( Sohn In-Sook ) - Konkuk University School of Medicine Department of Obstetrics and Gynecology
 ( Kim Soo-Nyung ) - Konkuk University School of Medicine Department of Obstetrics and Gynecology
 ( Kang Soon-Beom ) - Konkuk University School of Medicine Department of Obstetrics and Gynecology

Abstract


Objective: To determine whether local bupivacaine injection into the incision site after gynecologic laparoendoscopic single site surgery (LESS) improves postoperative pain.

Methods: This prospective cohort study included consecutive 158 patients who had LESS for benign adnexal disease from March 2013 to December 2015. Chronologically, 82 patients (March 2013 to August 2014) received no bupivacaine (group 1) and 76 (August 2014 to December 2015) received a bupivacaine block (group 2). For group 2, 10 mL 0.25% bupivacaine was injected into the 20 mm-incision site through all preperitoneal layers after LESS completion. Primary outcome is postoperative pain score using the visual analog scale (VAS).

Results: There was no difference in clinicopathological characteristics between the groups. Operating time (expressed as median [range], 92 [55?222] vs. 100 [50?185] minutes, P=0.137) and estimated blood loss (50 [30?1,500] vs. 125 [30?1,000] mL, P=0.482) were similar between the groups. Post-surgical VAS pain scores after 3 hours (3.5 [2?6] vs. 3.5 [2?5], P=0.478), 6 to 8 hours (3.5 [2?6] vs. 3 [1?8], P=0.478), and 16 to 24 hours (3 [2?4] vs. 3 [1?7], P=0.664) did not differ between groups.

Conclusion: Bupivacaine injection into the trocar site did not improve postoperative pain after LESS. Randomized trials are needed to evaluate the benefits of local bupivacaine anesthetic for postoperative pain reduction.

키워드

Local anesthesia; Laparoscopy; Pain; Minimally invasive surgical procedures
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