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  • Title: A prospective, randomized, double-blind, placebo-controlled trial of multimodal intraoperative analgesia for laparoscopic excision of endometriosis.
    Author: Costello MF, Abbott J, Katz S, Vancaillie T, Wilson S.
    Journal: Fertil Steril; 2010 Jul; 94(2):436-43. PubMed ID: 19394603.
    Abstract:
    OBJECTIVE: To assess the efficacy of multimodal intraoperative analgesia in reducing postoperative pain and/or opioid requirements in women undergoing laparoscopic excision of endometriosis. DESIGN: Prospective, randomized, double-blind, placebo-controlled trial. SETTING: Endogynecologic department of a university teaching hospital. PATIENT(S): Women booked for laparoscopic excision of endometriosis. INTERVENTION(S): Intraoperative multimodal analgesia versus placebo. Analgesia consisted of Diclofenac sodium 100 mg suppository per rectum and 0.75% Ropivacaine to portal sites, subperitoneally under excision sites and topically to each subdiaphragmatic area. MAIN OUTCOME MEASURE(S): Postoperative total hospital opioid analgesic requirements and postoperative pain intensity. RESULT(S): The study was terminated prematurely, after a planned interim analysis (which included 66 randomized patients or 43% of the planned number of patients) found significantly less total hospital opioid requirements in the analgesic group compared with the placebo group (19.0 mg vs. 34.5 mg; difference -14.0 mg [95% confidence interval -26.0 to -2.0 mg]). There was no difference in postoperative pain intensity between the two groups. CONCLUSION(S): The use of multimodal intraoperative analgesia at laparoscopic excision of endometriosis reduces postoperative opioid requirements.
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