Effect of incision infiltration anesthesia at different time points on analgesia after laparoscopic hysterectomy

QIN Xiaofeng; HUANG Qiurui; XU Jing; LI Hua; TU Weifeng

doi:10.3969/j.issn.2096-2681.2024.06.009

Abstract：Objective To compare the analgesic effect of local infiltration anesthesia on laparoscopic hysterectomy at two different time points,before surgical incision and before suturing at the end of surgery.Methods Ninety patients,aged 32-60 years,BMI 18.5-23.9 kg/m2,ASA Ⅰ or Ⅱ,underwent elective laparoscopic hysterectomy.The patients were divided into 3 groups,control group(group A,n=30),local infiltration anesthesia group before operation(group B,n=30),and local infiltration group after operation(group C,n=30),according to random number table method.The local anesthetic formula is 0.33％ropivacaine+0.67％lidocaine,totaling 15 mL.All three groups received slow intravenous injection of 50 mg flurbiprofen axetil 15 min before the end of the surgery.The pain scores of three groups of patients at 2,6,12,24,and 48 h after surgery were recorded,and the frequency of rescue analgesia within 48 h after surgery,the time of first ambulation after surgery,and the occurrence of postoperative complications were compared among three groups.Results Compared with group A,the pain scores of group B and group C was significantly reduced at 2,6,12,and 24 h after surgery(P＜0.05);and the pain scores of group B at 2,6,12,and 24 h after surgery were lower than those in group C(P＜0.05);the rescue analgesia rate of group B within 48 h postoperatively was lower than those of group A and group C(P＜0.05).There was no statistically significant difference in postoperative pain scores,first mobilization time and the incidence of complications among three groups of patients at 48 h after surgery.Conclusion Compared with patients receiving local infiltration of the incision before suturing,patients undergoing laparoscopic hysterectomy have better postoperative analgesic effects after local infiltration of the incision before surgery.