• Ana-Marija Hristovska, Billy B Kristensen, Marianne A Rasmussen, Yvonne H Rasmussen, Lisbeth B Elving, Christian V Nielsen, and Henrik Kehlet.
• Department of Anesthesiology, Hvidovre University Hospital, Copenhagen University, Copenhagen, Denmark.
• Acta Obstet Gynecol Scand. 2014 Mar 1;93(3):233-8.

ObjectiveTo assess the effect of systematic local infiltration analgesia on postoperative pain in vaginal hysterectomy, and describe the technique in detail.DesignA randomized, double-blind, placebo-controlled study following the CONSORT criteria.SettingA university hospital.PatientsThirty-seven patients undergoing vaginal hysterectomy.MethodsPatients received high-volume (50 mL) ropivacaine 0.50% (n = 20) or saline (n = 17) infiltration using a systematic technique ensuring uniform delivery to all tissues incised, handled or instrumented during the procedure.Main Outcome MeasuresPain, nausea, vomiting and opioid requirements were assessed for 32 h as well as time spent in the post-anesthesia care unit and time to first mobilization.ResultsPain at rest was significantly reduced after one, four and eight hours in the ropivacaine group (p ≤ 0.001-0.01). Pain during coughing was significantly reduced after one and four hours (p ≤ 0.001 and p ≤ 0.003), and pain during movement was significantly reduced after four hours (p ≤ 0.02). Opioid requirements and time spent in the post-anesthesia care unit were significantly reduced in the ropivacaine group (p < 0.001 and p < 0.001, respectively), as well as the time to first mobilization (p < 0.001).ConclusionIntra-operative systematic local infiltration analgesia reduces postoperative pain in patients undergoing vaginal hysterectomy, facilities mobilization and improves early recovery.© 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

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