Transcervical or intraperitoneal analgesia for laparoscopic tubal sterilization: A randomized controlled trial

Objective: To test the effectiveness of analgesia administered transcervica lly through a uterine manipulator compared with direct topical application to the fallopian tubes for relief of postoperative pain after interval lapa roscopic tubal sterilization. Methods: Sixty-one women who had laparoscopic sterilization were enrolled i n a randomized, double-masked clinical trial comparing analgesia with 75 mg of bupivacaine administered through a uterine manipulator with 75 mg of bu pivacaine applied directly to the fallopian tubes through a secondary troca r. Results were evaluated using visual analog scale pain levels, time of ad ministration of analgesics, total analgesics required, and recovery room ti mes. We calculated that a sample size of 60 women would detect a 30% differ ence in pain levels with a power of 80% at a significance level of .05. Results: In the 59 women who completed the study, there were no differences in the two groups in pain levels, amounts of medications used, or times to administration of postoperative analgesia. Mean recovery room time was sho rter in the group given analgesia transcervically, but that difference was not statistically significant. Conclusion: There were no significant differences in postoperative pain rel ief between transcervical administration and topical application of analges ia for laparoscopic tubal sterilization. (Obstet Gynecol 2000;96:895-8. (C) 2000 by The American College of Obstetricians and Gynecologists.).