Intraperitoneal lidocaine for decreasing intra-operative pain during postpartum tubal resection in Srinagarind Hospital.

OBJECTIVE

To evaluate the effectiveness and determine the minimal dosage of intraperitoneal lidocaine for pain relief during postpartum tubal resection in Srinagarind Hospital.

MATERIAL AND METHOD: Sixty postpartum women, undergoing postpartum tubal resection performed by residents at the Department of obstetrics and gynecologic, were included in this randomized, double-blinded, placebo controlled study. They were randomly assigned to one of three groups. They all received 20 ml solution intraperitoneally. Group one received it as isotonic normal saline; group 2 received it with 100 mg of lidocaine; and group 3 received it with 200 mg of lidocaine. The intra-operative and post-operative pain was measured by using a numerical rating score (NRS, from 0-10).

RESULTS

The mean of intra-operative NRS in the lidocaine groups (100 and 200 mg) were significantly lower than the isotonic normal saline group (3.40, 3.50 vs. 6.55, p-value 0.019 and 0.024). No significant difference was found in the intra-operative NRS between 100 and 200 mg lidocaine (NRS 3.40 vs. 3.50, respectively, mean difference 95% CI -2.41 to 2.21). There was no significant difference in the immediate post-operative pain among these three groups (p-value 0.613).

CONCLUSION

Intraperitoneal lidocaine instillation provides effective intra-operative pain relief in postpartum tubal resection under local anesthesia. 100 mg of lidocaine is effective in pain relief This technique was not effective for relief of immediate post-operative pain.