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- W4309929523 abstract "<h3>Study Objective</h3> To determine the effect of laparoscopic uterosacral bupivacaine injection on post-operative pain and opioid usage in patients undergoing minimally invasive hysterectomy. <h3>Design</h3> Single-Blinded, Triple-Arm, Randomized Controlled Trial. <h3>Setting</h3> Academic Hospital Center. <h3>Patients or Participants</h3> Patients undergoing benign MIGS hysterectomy between 3/15/2021 and 4/8/2022. Exclusion criteria: conversion to laparotomy, bupivacaine allergy, concurrent procedures, supracervical hysterectomy, TAP block, preoperative opioid usage, non-English speaking. <h3>Interventions</h3> Patients were randomized in a 1:1:1 fashion to the following before colpotomy: no injection, 20cc normal saline, or 20cc of 0.25% bupivacaine. All patients received incisional infiltration with 10cc 0.25% bupivacaine. Post-operative pain scores, total opioid consumption and return of bowel function were recorded via Qualtrics surveys. <h3>Measurements and Main Results</h3> Of 360 hysterectomies screened, 298 were eligible (83%), 161 (45%) agreed to participate, and 125 were ultimately included in interim analysis. The majority of hysterectomies were performed laparoscopically (91, 73%) and the remainder robotically. Most hysterectomies were discharged home POD#0 (116, 93%). Patients randomized to placebo had a lower proportion of public insurance and higher proportion of mood disorders. There was a statistical difference in the proportion of cases that required morcellation between bupivacaine and no injection (43% vs 18%, p=0.038; no difference between bupivacaine and saline, 43% and 32%, p=0.87). In regression controlling for surgical approach, administration of Toradol, and time from injection to discharge, mean pain scores on VAS at time of discharge were statistically lower in the bupivacaine group compared to placebo (-1.09, p=0.033) or no injection (-1.15, p=0.023). There was no difference between groups in PACU OME administration or post-operative OME usage, day of last use, or return of bowel function. <h3>Conclusion</h3> Laparoscopic uterosacral injection of bupivacaine at the time of MIS hysterectomy results in decreased post-operative VAS pain scores, although without a difference in post-operative opioid consumption. Complete trial data to be available at the time of AAGL." @default.
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- W4309929523 date "2022-11-01" @default.
- W4309929523 modified "2023-09-29" @default.
- W4309929523 title "Laparoscopic Uterosacral Bupivacaine Injection during Minimally-Invasive Hysterectomy: A Single-Blinded Randomized Controlled Trial" @default.
- W4309929523 doi "https://doi.org/10.1016/j.jmig.2022.09.106" @default.
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