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Bupivacaine injection during midurethral sling and postoperative pain: a randomized controlled trial

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Abstract

Introduction and hypothesis

The aim of this study was to investigate the impact of retropubic injection of 0.125% bupivacaine during midurethral sling placement on postoperative pain.

Methods

A randomized, double-blind trial of 42 women undergoing midurethral sling for stress incontinence was conducted. The intervention group received an injection of 0.125% bupivacaine in the retropubic space prior to midurethral sling placement, while the control group received no injection. Pain scores were recorded via a 10-cm visual analog scale at 2, 6, and 24 h postoperatively.

Results

Pain scores were lower in the bupivacaine group compared to the control group at 2 h (1.9 versus 2.6, p = 0.05). Mean pain scores were similar at all other time points (all p > 0.45). Participants in both groups used similar amounts of pain medication in the hospital, except that patients in the bupivacaine group used more PO non-steroidal anti-inflammatory drugs (p = 0.047).

Conclusions

Retropubic injection of 0.125% bupivacaine at the time of midurethral sling placement decreases short-term postoperative pain.

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Abbreviations

SPARC:

Suprapubic arc

UNC:

University of North Carolina

NSAIDs:

Non-steroidal anti-inflammatory drugs

VAS:

Visual analog scale

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Acknowledgment

This study was supported by award number 2KR20814 from the North Carolina Translational and Clinical Sciences Institute.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, 3032 Old Clinic Building, Campus Box 7570, Chapel Hill, NC, 27599-7570, USA

    Gena C. Dunivan, Brent A. Parnell, AnnaMarie Connolly, Mary L. Jannelli & Elizabeth J. Geller

  2. Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, 3032 Old Clinic Building, Campus Box 7570, Chapel Hill, NC, 27599-7570, USA

    Bethany Jablonski Horton

Authors
  1. Gena C. Dunivan
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  2. Brent A. Parnell
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  3. AnnaMarie Connolly
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  4. Mary L. Jannelli
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  5. Bethany Jablonski Horton
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  6. Elizabeth J. Geller
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Corresponding author

Correspondence to Elizabeth J. Geller.

Additional information

Clinical trial registration: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00746863

This paper was presented orally at the 2009 American Urogynecologic Society Annual Meeting, Hollywood, FL, September 24–26th, 2009.

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Dunivan, G.C., Parnell, B.A., Connolly, A. et al. Bupivacaine injection during midurethral sling and postoperative pain: a randomized controlled trial. Int Urogynecol J 22, 433–438 (2011). https://doi.org/10.1007/s00192-011-1362-y

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  • DOI: https://doi.org/10.1007/s00192-011-1362-y

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