Original Research Paracervical block in laparoscopic hysterectomy for postoperative pain control: a randomized, multi-center, double-blind, placebo-controlled trial

Abstract

Paracervical block in laparoscopic hysterectomy for postoperative pain control: a randomized, multi-center, double-blind, placebo-controlled trial San-Hui Lee1 , Tae-Joong Kim2 , Nae Hyun Lee3 , Soo Young Jeong4 , Jimin Lee1 , Taejong Song3,* 1Department of Obstetrics & Gynecology, Wonju Severance Christian Hospital, 26426 Wonju, Republic of Korea 2Department of Obstetrics & Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 03181 Seoul, Republic of Korea 3Department of Obstetrics & Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 03181 Seoul, Republic of Korea 4Department of Obstetrics & Gynecology, Kangnam Sacred-Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, 07441 Seoul, Republic of Korea *Correspondence: taejong.song@gmail.com (Taejong Song) Academic Editor: Christos Iavazzo Submitted: 9 June 2021 Revised: 5 July 2021 Accepted: 9 July 2021 Published: 9 March 2022 Abstract Background: To determine the effect of a paracervical block in laparoscopic hysterectomy on postoperative pain relief. Method: A total of 86 patients scheduled for total laparoscopic hysterectomy for benign gynecologic diseases were randomly assigned to the experimental group (n = 43) and the control group (n = 43). Patients were received a paracervical injection that was either 10 mL of 0.5% bupivacaine with 1 : 200,000 epinephrine or 10 mL of normal saline. The primary outcome was the postoperative pain score which was assessed using a visual analog scale at 2, 4, 6, 8, and 12 hours after surgery. The secondary outcome was the postoperative rescue analgesic requirement within 12 hours after surgery. Results: Baseline characteristics were similar in both groups. Postoperative pain scores did not significantly differ between groups. Rescue analgesia requirements were also statistically similar in both groups. Conclusion: Adding a paracervical block with preemptive local analgesia in patients undergoing laparoscopic hysterectomy did not reduce postoperative pain and postoperative rescue analgesia requirements. Keywords: Hysterectomy; Paracervical block; Pain