Efficacy of intraperitoneal bupivacaine,hydrocortisone, and magnesium sulfatein different combinations for pain reliefafter laparoscopic ovarian cystectomy:a double-blind randomized controlled trial

摘要

The aim of this study was to assess the efficacy of intraperitoneal different combinations for postop- erative pain relief in patients undergoing laparoscopic unilateral ovarian cystectomy.METHODS: We conducted a double-blind randomized controlled trial that enrolled patients who were included to undergo laparoscopic unilateral ovarian cystectomy. Patients received one of the following combinations (30 patients each):group I: received bupivacaine plus magnesium sulfate, group II: received bupivacaine plus hydrocortisone, group III:received magnesium sulfate plus hydrocortisone, and group IV: received saline 0.9% only. The primary outcomes inthe present study were the severity of postoperative abdominal and shoulder pain assessed by visual analog scale (VAS)every two hours till the end of the first day, and time for first postoperative analgesia requirement.RESULTS: Group I had statistically significant lower abdominal static and dynamic pain scores than the other groups till18 hours postoperatively (P<0.001). In addition, group II had statistically significant lower abdominal static and dynamicpain scores than group III in the most of assessment points (P<0.05). The time for first required analgesics was significantly longer in group I (336.2±67.54 minutes) than other groups (P<0.001). The proportion of patients who required twoor more doses of ketorolac was significantly lower in group I than other groups (P 0.05).CONCLUSIONS: Intraperitoneal bupivacaine-magnesium combination provides better analgesia and reduces postoperative morphine consumption than bupivacaine-hydrocortisone or magnesium-hydrocortisone combinations after laparoscopic ovarian cystectomy.