Ibuprofen and Intraperitoneal Lidocaine Instillation for Relieving Intraoperative Pain during Postpartum Tubal Ligation via Minilaparotomy: A Randomized Controlled Trial

Abstract

Objectives: This randomized study evaluated the effects of preemptive ibuprofen, intraperitoneal lidocaine instillation, or both for pain relief during postpartum tubal ligation (PPTL) via minilaparotomy.
Materials and Methods: Ninety-two heathy mothers who opted for PPTL were randomized into four groups and received either 400 mg of oral ibuprofen and intraperitoneal instillation of 20 ml of isotonic sodium chloride solution (Group I), oral placebo and intraperitoneal instillation of 20 ml of 1% lidocaine 20 ml (Group L), both ibuprofen and intraperitoneal instillation lidocaine (Group IL), or placebo and intraperitoneal isotonic sodium chloride solution (Group P).
Results: The mean intraoperative numerical rating scale (NRS) in group IL was significantly lower than in group P (mean difference -2.48, 95% CI -4.47 to -0.49, p = 0.007). No significant difference was found in the intra-operative NRS between groups I and L when compared to group P (mean difference -1.61 [95% CI -3.60 to 0.38], and 0.70 [95% CI -1.29 to 2.69], respectively), nor was there any significant difference in pain score immediately or one-hour post-operation.
Conclusion: Preemptive ibuprofen and intraperitoneal lidocaine instillation alone did not provide effective pain relief for postpartum tubal resection. However, multimodal analgesia using both agents was effective as intra-operative (but not post-operative) pain control.