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. 2023 May 18;12(2):90-95.
doi: 10.4103/gmit.gmit_125_21. eCollection 2023 Apr-Jun.

Vaginal Vault Infiltration with Bupivacaine for Postoperative Pain Control after Total Laparoscopic Hysterectomy: A Randomized control trial

Kallol Kumar Roy  1 , Poojitha Kalyani Kanikaram  1 , Nilanchali Singh  1 , Vimi Riwari  2 , Rinchen Zangmo  1 , Jyoti Meena  1 , Anamika Das  1 , Deepika Kashyap  1 , Archana Minz  1
Affiliations

Vaginal Vault Infiltration with Bupivacaine for Postoperative Pain Control after Total Laparoscopic Hysterectomy: A Randomized control trial

Kallol Kumar Roy et al. Gynecol Minim Invasive Ther. .

Abstract

Objectives: The objective of this study was to assess the effect of local infiltration of anesthetic to the vaginal vault on postoperative pain after total laparoscopic hysterectomy.

Materials and methods: This was a single-center, randomized trial. Women assigned to laparoscopic hysterectomy were randomly divided into two groups. In the intervention group (n = 30), the vaginal cuff was infiltrated with 10 ml of bupivacaine, whereas the control group (n = 30) did not receive local anesthetic infiltration to vaginal vault. The primary outcome measure was to analyze the efficacy of bupivacaine infiltration in the study group by comparing the postoperative pain in both the groups at 1, 3, 6, 12, and 24 h using pain visual analog scale (VAS). The secondary outcome was to measure the need for rescue opioid analgesia.

Results: Group I (intervention group) had lesser mean VAS score at 1st, 3rd, 6th, 12th, and 24 h compared to Group II (control group). There was an additional requirement of opioid analgesia for postoperative pain in Group II than in Group I, which was statistically significant (P < 0.05).

Conclusion: Injection of local anesthetic into the vaginal cuff increased the number of women experiencing only minor pain after laparoscopic hysterectomy and decreased postoperative opioid usage and its side effects. Local anesthesia of the vaginal cuff is safe and feasible.

Keywords: Hysterectomy; laparoscopy; local analgesia; postoperative pain; vaginal vault.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Flowchart 1
Flowchart 1
Consort diagram of the study
Figure 1
Figure 1
Infiltration of bupivacaine in to the vaginal vault laparoscopically using aspiration needle
See this image and copyright information in PMC

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