Evaluation of the analgesic effect of Intraperitoneal instillation of lidocaine with and without meperidine versus non-steroidal anti-inﬂammatory drugs during and after gynecological laparoscopic procedures

Radwan, Ahmed M.; Girbash, Ehab F.; Taema, Mohamed I

doi:10.21608/egyfs.2024.343710

Evaluation of the analgesic effect of Intraperitoneal instillation of lidocaine with and without meperidine versus non-steroidal anti-inﬂammatory drugs during and after gynecological laparoscopic procedures

Document Type : Original Article

Authors

¹ Assistant Professor of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University

² Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University

³ Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University

10.21608/egyfs.2024.343710

Abstract

Background: Drugs are used in a wide range to control pain as they are easy to apply by any route, fast, and effective. Also, they do not need special skills or techniques. But it may be dangerous if overdoses are given, leading to addiction or withdrawal symptoms, especially if used alone without sedation or muscle relaxant.
Methods: In this study, two hundred cases were classiﬁed into four groups of patients undergoing minor laparoscopic procedures as diagnostic, ovarian drilling, adhesiolysis, ovarian cystectomy, ectopic pregnancy, endometriosis ablation, etc. Every group included 50 patients. Group I received intraperitoneal lidocaine. Group II received intraperitoneal lidocaine with meperidine. Group III received intramuscular NSAID drugs (diclofenac sodium) 75 mg. Group IV received intraperitoneal saline. Postoperative pain was assessed using a numeric pain rating scale. A highly signiﬁcant difference between Group II and Group I or III was seen when the pain score across the four groups was examined at 0, 2, and 6 hours postoperatively. Comparing Group IV to the other groups, it is highly significant (high score). When the pain scores from the four groups were assessed at 12 hours postoperatively, groups I and II revealed a signiﬁcant difference compared to group III. Comparing Group IV to the other groups reveals it is highly signiﬁcant. So, We concluded that the "intraperitoneal lidocaine with or without meperidine" procedure was simple, risk-free, and without side effects. In contrast to non-steroidal anti-inﬂammatory drugs, intraperitoneally administered lidocaine, both with and without meperidine, signiﬁcantly reduces postoperative discomfort after minor gynecologic laparoscopic surgery.