An assessment of the value of rectus sheath block for postlaparoscopic pain in gynecologic surgery.

Study Objective: To compare the effect of the bilateral rectus sheath block (BRSB) by bupivacaine in decreasing postlaparoscopic pain with the intraperitoneal (IP) and intraincisional (II) use of this drug.

Design: Randomized, double-blind, clinical trial (Canadian Task Force Classification I).

Setting: University teaching hospital.

Patients: Ninety-one women with unexplained infertility.

Measurements And Main Results: Patients were randomly allocated to one of three groups. In group I, BRSB was performed with 25 mg of bupivacaine. For groups II and III, IP and II instillation, respectively, of 25 mg of bupivacaine was performed. Postoperative pain was assessed by visual analog pain score (VAS) 1, 6, 10, and 24 hours postoperatively. The VAS was significantly lower in group I at 6 hours (p <.001) and 10 hours (p <.004) after laparoscopy.

Conclusion: Bilateral rectus sheath block can effectively decrease postlaparoscopic pain at 6 and 10 hours after the operation when compared with IP and II use of bupivacaine.