Study objective: To compare the effect of intraperitoneal bupivacaine and lidocaine on reducing pain after diagnostic laparoscopy.
Design: Randomized, double-blind, placebo-controlled study (Canadian Task Force classification I).
Setting: University teaching hospital.
Patients: One hundred thirty-four women with unexplained infertility.
Intervention: Diagnostic laparoscopy with intraperitoneal administration of bupivacaine or lidocaine.
Measurements and main results: Patients were randomized into one of four groups. In group A, at the end of laparoscopy 0.125% bupivacaine 30 ml was instilled into the pelvic cavity and the same dose was instilled over the diaphragmatic vault. Groups B and C received the same volume of 5% lidocaine and normal saline, respectively. Group D received no intraperitoneal agent. The verbal pain scale questionnaire was used to assess postoperative pain. Pain scores 2 and 24 hours postoperatively were significantly lower for group A than for groups B and C (p = 0.0001). Scores in group B were also significantly lower than those in groups C and D (p = 0.0001). Women in group A required less additional analgesia than those in the other groups.
Conclusion: Compared with lidocaine and placebo, intraperitoneal bupivacaine significantly decreased postoperative pain, and this effect was long lasting.