Systematic Review and Metaanalysis of Intraperitoneal Instillation of Local Anesthetics for Reduction of Pain After Gynecologic Laparoscopy

Marks J. L. , Ata B., Tulandi T.

JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY, vol.19, no.5, pp.545-553, 2012 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Review
  • Volume: 19 Issue: 5
  • Publication Date: 2012
  • Doi Number: 10.1016/j.jmig.2012.04.002
  • Page Numbers: pp.545-553


We reviewed the effectiveness of intraperitoneal instillation of local anesthetic on pain after gynecologic laparoscopic surgery. Sources included the Cochrane Central Register of Controlled Trials, MEDLINE/PubMed, EMBASE, and Ovid MEDLINE In-Process & Other Non-Indexed Citations databases, and abstracts, reference lists, and randomized controlled trial (RCT) registries. The 7 included RCTs compared pain scores after administration of intraperitoneal analgesics or placebo/control during gynecologic laparoscopic surgery with benign indications. Outcome measures were pain scores (per visual analog scale) at 1 to 2, 4 to 6, and 24 hours postoperatively. Pain scores were significantly lower in the groups receiving local anesthesia at 1 to 2 hours (weighted mean difference [WMD], -1.82; 95% confidence interval [CI], -2.55 to -1.08]) and 4 to 6 hours postoperatively (WMD, -2.00; 95% CI, -3.64 to -0.35), but were similar at 24 hours (WMD, -1.43; 95% CI, -1.15 to 0.96). Local analgesia instilled intraperitoneally significantly decreased pain during a 6-hour interval after gynecologic laparoscopy. Journal of Minimally Invasive Gynecology (2012) 19, 545-553 (c) 2012 AAGL. All rights reserved.