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Randomized trial of preemptive local analgesia in vaginal surgery

International Urogynecology Journal volume 20, Article number: 5 (2009) Cite this article

Abstract

Preemptive analgesia in vaginal surgery has had conflicting efficacy reported in the existing literature. This study was designed to clarify the usefulness of preemptive local analgesia (PLA) in patients undergoing vaginal hysterectomy. A prospective, randomized, double-blinded trial of PLA in 90 women undergoing vaginal hysterectomy was conducted. PLA consisted of 20 ml of 0.5% bupivacaine with 1:200,000 epinephrine injected in a paracervical-type fashion. Total narcotic use and pain (using a visual analog scale (VAS)) was recorded at 30 min, 3, 12, and 24 h postoperatively. The mean total dose of narcotic was significantly less in the PLA group versus the placebo group (P = 0.009) at every time point postoperatively. Additionally, the mean pain VAS 30 min and 3 h postoperatively was 43% (P = 0.003) and 33% (P = 0.02) lower, respectively, in the PLA group. PLA with bupivacaine prior to vaginal hysterectomy is associated with significantly lower pain scores and a reduction in narcotic use postoperatively.

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Abbreviations

PLA:

Preemptive local analgesia

CI:

Confidence interval

SD:

Standard deviation

VAS:

Visual analogue scale

ml:

Milliliter

kg:

Kilograms

μg:

Micrograms

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Acknowledgments

This study was funded by an intramural grant from Mayo Clinic. We would also like to thank Dobie L. Giles and Mohamed Akl for their involvement and support of this study in our department.

Conflicts of interest

None.

Author information

Affiliations

  1. Department of Gynecologic Surgery, Mayo Clinic, Scottsdale, AZ, USA

    Jaime B. Long, Rhonda J. Eiland, Paul M. Magtibay, Rosanne M. C. Kho, Javier F. Magrina & Jeffrey L. Cornella

  2. Department of Biostatistics, Mayo Clinic, Scottsdale, AZ, USA

    Joseph G. Hentz

  3. Department of Anesthesiology, Mayo Clinic, Scottsdale, AZ, USA

    Pamela A. Mergens

  4. Department of Obstetrics and Gynecology, Mayo Clinic, 5777 East Mayo Blvd., Phoenix, AZ, 85054, USA

    Jeffrey L. Cornella

Authors
  1. Jaime B. Long
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  2. Rhonda J. Eiland
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  3. Joseph G. Hentz
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  4. Pamela A. Mergens
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  5. Paul M. Magtibay
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  6. Rosanne M. C. Kho
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  7. Javier F. Magrina
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  8. Jeffrey L. Cornella
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Corresponding author

Correspondence to Jeffrey L. Cornella.

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Long, J.B., Eiland, R.J., Hentz, J.G. et al. Randomized trial of preemptive local analgesia in vaginal surgery. Int Urogynecol J 20, 5 (2009). https://doi.org/10.1007/s00192-008-0716-6

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  • DOI: https://doi.org/10.1007/s00192-008-0716-6

Keywords

  • Analgesia
  • Paracervical block
  • Hysterectomy
  • Vaginal