To determine whether postoperative pain and nausea after laparoscopic sterilization can be reduced with a combination of bupivacaine, metoclopramide, scopolamine, ketorolac, and gastric suctioning.
Women undergoing outpatient laparoscopic sterilization were randomized to protocol management or nontreatment groups.
Each patient received standard general endotracheal anesthesia.
The nontreatment group served as controls.
Visual analogue scales were used to evaluate pain and nausea (measured in millimeters).
During a 7-month period, 71 women were enrolled.
Protocol subjects (N=35) reported pain severity of 27.9±19.1 mm (mean±standard deviation), whereas controls (N=36) reported 59.3±23.3 mm (P<. 001).
Fourteen protocol patients requested additional pain medication, compared with 29 controls (P<. 001), Protocol patients indicated a nausea severity of 9.9±18.7 mm, whereas the controls reported 38.8±35.5 mm (P<. 001).
Only one protocol patient required nausea medication.
Severity of pain correlated with severity of nausea (r=0.38166, P<. 001).
This regimen reduced the severity of pain and nausea after outpatient laparoscopic sterilization.
The need for additional analgesics and antiemetics was also reduced.
Protocol patients were disharged earlier than controls.
These benefits seem to accrue without significant risk.
We believe that this regimen may also be useful in other ambulatory laparoscopic procedures.
Mots-clés Pascal : Douleur, Postopératoire, Nausée, Laparoscopie, Chirurgie, Stérilisation femelle, Bupivacaïne, Métoclopramide, Scopolamine, Kétorolac, Aspiration, Estomac, Analgésique, Antiémétique, Analyse avantage coût, Chirurgie coelioscopique
Mots-clés Pascal anglais : Pain, Postoperative, Nausea, Laparoscopy, Surgery, Female sterilization, Aspiration, Stomach, Analgesic, Antiemetic, Cost benefit analysis, Laparoscopic Surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0336957
Code Inist : 002B20A02. Création : 01/03/1996.