Journal of

 Introduction: Several mehods have been proposed to alleviate pain after hysterectomy. Pre-emptive analgesia has been used to relieve pain following abdominal hysterectomy with conflicting results. This study was performed to evaluate the efficacy of pre-incision skin infiltration of Lidocaine in relieving postoperative pain in patients undergoing abdominal hysterectomy. 

Methods: 60 patients with ASA class of I or II scheduled for abdominal hysterectomy were recruited for the study. The patients were randomly assigned to receive pre-incision skin infiltration of either lidocaine or normal saline. The patients were evaluated with respect to postoperative pain scores and analgesic requirements in the first two postoperative days. They were also asked for satisfaction regarding the pain relief intervention.

Results: The patients were similar with respect to demographic characteristics. Patients in the saline group complained of more pain than the lidocaine group in the recovery room(p<0.001). However, the patients were similar with respect to postoperative pain scores and analgesic requirements. They were also similar regarding satisfaction rates during the first 24 hours postoperatively.

 Conclusions: We conclude that pre-incision skin infiltration of lidocaine is not effective in reducing postoperative pain following abdominal hysterectomy and does not affect the patients’ satisfaction. 

 Introduction: shorter hospital stay and less pain in comparison to open surgery considered to be major benefits for laparoscopic cholecystectomy. We compared the effect of intraperitoneal hydrocortisone plus bupivacaine with bupivacaine alone on pain relief following laparoscopic cholecystectomy. 

Methods: Sixty two patients participated in this double-blind, randomized clinical trial. Patients randomly received intraperitoneal instillation of either 100 mg bupivacaine in 250 ml normal saline (n=32) or 100 mg hydrocortisone plus 100 mg bupivacaine in 250 ml normal saline (n=30) before insufflation of CO₂ into the peritoneum. Abdominal and shoulder pain were evaluated using VAS postoperatively. The patients were also followed for postoperative analgesic requirements, nausea and vomiting, and return of bowel function. 

We used independent Student t-test and Chi-square test and Mann-Whitney U tests with SPSS software to compare quantitative and qualitative variables, respectively. P value less than 0.05 was considered significant. 

 Results: Sixty patients completed the study. Patients in the hydrocortisone plus bupivacaine group had significantly lower abdominal and shoulder pain scores (11.72 vs 8.92 in the bupivacaine and bupivacaine plus hydrocortisone group, respectively P<0.01). The patients were similar regarding analgesic requirements .The patients were similar with respect to return of bowel function, nausea and vomiting. No adverse reaction was observed in either group. 

Conclusions: Intraperitoneal administrations of hydrocortisone plus bupivacaine can alleviate pain after laparoscopic cholecystectomy better than intraperitoneal bupivacaine alone.