Treatment for postoperative wound pain in gynecologic laparoscopic surgery:
topical lidocaine patches.
Author(s): Kwon YS, Kim JB, Jung HJ, Koo YJ, Lee IH, Im KT, Woo JS, Im KS.
Affiliation(s): Department of Obstetrics and Gynecology, College of Medicine, University of
Ulsan, Ulsan University Hospital, Ulsan, Korea.
Publication date & source: 2012, J Laparoendosc Adv Surg Tech A. , 22(7):668-73
BACKGROUND: This article reports our early experience with the use of lidocaine
patches for pain control in the immediate postoperative period after laparoscopic
gynecologic surgery.
SUBJECTS AND METHODS: A prospective, double-blind, placebo-controlled clinical
trial was conducted on 40 patients undergoing a gynecologic laparoscopy who were
randomized to receive either topical patches of 700 mg of lidocaine (n=20) or
placebo patches (n=20). The patch was divided evenly into four smaller patches,
which were applied at the four port sites and changed every 12 hours for 36 hours
after surgery. Postoperative pain was evaluated using the visual analog scale
(VAS) score and the Prince Henry and 5-point verbal rating pain scale (VRS), and
the analgesic requirement was also evaluated at 1, 6, 12, 24, and 36 hours after
surgery.
RESULTS: The VAS score for wound pain was lower in the lidocaine patch group at 1
and 6 hours after surgery than the control group (P=.005 and <.0005,
respectively). The VAS scores for postoperative pain were lower in the lidocaine
patch group at rest 1 hour after surgery (P=.045). The 5-point VRS score for
postoperative pain was lower in the lidocaine patch group at 6 and 12 hours after
surgery (P=.015 and .035, respectively) than in the control group.
CONCLUSIONS: Topical lidocaine patches at the laparoscopic port sites reduced
postoperative pain, particularly postoperative wound pain after gynecological
laparoscopic procedures.
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