Tubal surface lidocaine mediates pre-emptive analgesia in awake laparoscopic sterilization: A prospective, randomized clinical trial

OBJECTIVE: The purpose of this study was to determine whether lidocaine that is instilled onto the Fallopian tubes reduces pain scores in awake patients who undergo laparoscopic sterilization with Filshie clips. STUDY DESIGN: This was a prospective, randomized, placebo-controlled, double-blinded, clinical trial study that was approved by our institutional review board. RESULTS: Pain scores (visual analogue scales) were lower in the lidocaine group (n = 12 patients) than in the placebo group (n = 12 patients) at clip application (6 vs 71 mm; P < .0001) and after 15 minutes after operation (15.5 vs 44.5 mm; P < .005). No significant differences occurred at 1-hour after operation or discharge, but more rescue analgesia was required in the placebo group ( P < .05), with more side effects ( P < .05). In a separate group of 20 women, serum lidocaine levels were measured (maximum level, 16.0 μmol/L). Holter monitoring of these patients revealed no significant arrhythmias. CONCLUSION: One percent lidocaine that is instilled onto the Fallopian tubes reduces pain scores in awake patients who undergo laparoscopic sterilization with Filshie clips. (Am J Obstet Gynecol 2002;186:383-8.)