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A Novel Injection Technique for Extended-Release Local Anesthetic After Posterior Colporrhaphy and Perineorrhaphy: A Randomized Controlled Study.
- Source :
-
Female pelvic medicine & reconstructive surgery [Female Pelvic Med Reconstr Surg] 2021 Jun 01; Vol. 27 (6), pp. 344-350. - Publication Year :
- 2021
-
Abstract
- Objectives: To evaluate the effect of vaginal intraoperative infiltration of liposomal bupivacaine on vaginal pain among patients undergoing posterior colporrhaphy and perineorrhaphy.<br />Methods: This was a randomized, placebo-controlled trial offered to women undergoing posterior colporrhaphy and perineorrhaphy with concomitant pelvic reconstructive procedures. Liposomal bupivacaine or normal saline placebo (30 mL) was injected into the posterior vaginal compartment and perineal body in 2- to 3-mL increments, using a systematic technique. All participants received 10-mL 0.25% bupivacaine with epinephrine prior to incision. Perioperative care was standardized. The primary outcome was vaginal pain as measured by a visual analog scale.<br />Results: One hundred twenty-six women were screened, and 72 were included. Demographic characteristics were similar. Median visual analog scale was not different at any time point (P = 0.81). There were no differences in secondary outcomes, including narcotic use (37.5 vs 37.5 mg morphine equivalents, P = 0.51; placebo vs liposomal bupivacaine), time to first opioid (68 vs 89.5 minutes, P = 0.56), antiemetic doses (3 vs 2, P = 0.07), hospital length of stay (24 vs 21.9 hours, P = 0.98), length of stay in postanesthesia care unit (93 vs 100 minutes, P = 0.32), proportion of patients who had a bowel movement within the first 3 postoperative days (65.7 vs 59.5% P = 0.36), or successful voiding trials (45.7 vs 59.5%, P = 0.24). There were no differences in patient satisfaction or postoperative adverse events.<br />Conclusions: In this study of pelvic reconstructive surgeries with posterior colporrhaphy and perineorrhaphy, there were no differences in pain scores or any secondary outcomes between liposomal bupivacaine and placebo injected into the posterior vaginal compartment.<br />Competing Interests: The authors have declared they have no conflicts of interest.<br /> (Copyright © 2020 American Urogynecologic Society. All rights reserved.)
- Subjects :
- Aged
Delayed-Action Preparations
Double-Blind Method
Female
Gynecologic Surgical Procedures methods
Humans
Injections
Liposomes
Middle Aged
Anesthesia, Local
Anesthetics, Local administration & dosage
Bupivacaine administration & dosage
Pain, Postoperative drug therapy
Pelvic Organ Prolapse surgery
Perineum surgery
Vagina surgery
Subjects
Details
- Language :
- English
- ISSN :
- 2154-4212
- Volume :
- 27
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Female pelvic medicine & reconstructive surgery
- Publication Type :
- Academic Journal
- Accession number :
- 32384288
- Full Text :
- https://doi.org/10.1097/SPV.0000000000000855