Intraperitoneal Bupivacaine-Meperidine Infiltration Versus Intravenous Paracetamol: A Comparison of Analgesic Efficacy in Post-Gynecologic Diagnostic Laparoscopic Pain.

BACKGROUND: Pain following laparoscopy could be due to different causes requiring effective postoperative analgesia.

OBJECTIVES: In the present study, we evaluated the combined effect of intraperitoneal infiltration of bupivacaine-meperidine versus intravenous infusion of paracetamol on pain relief after diagnostic gynecologic laparoscopy.

PATIENTS AND METHODS: In this prospective study, 90 female subjects with ASA class I or II scheduled for gynecologic diagnostic laparoscopy were studied in two groups; group B + M received intraperitoneal infiltration of 40 mL bupivacaine 0.25% with 50 mg of meperidine, group P received normal saline via abdominal trocar and ten minutes before the end of operation, group P received infusion of paracetamol 1000 mg in normal saline. Postoperative pain was evaluated using VAS score in PACU and 1, 2, 4, 8, 12 and 24 hours after the operation. The time to the first analgesic administration and total analgesic requirements were recorded.

RESULTS: Group B + M had significantly lower pain score in the first 8 postoperative hours than group P (P < 0.05). Rescue meperidine (IM) requirement was significantly less in B + M group compared to group P. Time to first request for analgesia was different between the two groups (78 versus 60 min); however, the difference was not statistically significant.

CONCLUSIONS: Intraperitoneal Infiltration of bupivacaine with meperidine following surgery provided more appropriate analgesia after gynecologic diagnostic laparoscopy than administration of IV paracetamol.