Local infiltration analgesia in urogenital prolapse surgery: a prospective randomized, double-blind, placebo-controlled study.

Objective: To evaluate the analgesic effect of high-volume infiltration analgesia in urogenital prolapse surgery and provide a detailed description of the infiltration technique.

Design: A randomized, double-blind, placebo-controlled study following the CONSORT criteria.

Setting: A university hospital.

Patients: 48 patients undergoing posterior wall repair and perineorraphy.

Methods: Patients received high-volume (26 ml) ropivacaine 1% with epinephrine (n=23) or saline (n=22) infiltration using a systematic technique ensuring uniform delivery to all tissues incised, handled or instrumented during the procedure.

Main Outcome Measures: Pain and opioid requirements were assessed for 24 hours as well as time spent in the post-anesthesia care unit and time to first mobilization.

Results: Pain at rest, during coughing and movement was significantly reduced for the first four hours with the high-volume local anesthetic infiltration technique (p<0.001-0.006). 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<0.014).

Conclusion: Systematic high-volume infiltration analgesia is an effective analgesic technique in patients undergoing posterior wall repair and perineorraphy, and improves early recovery.