Objective: To compare preemptive analgesia and preclosure analgesia in reducing wound pain after laparoscopic operation.
Design: Randomised, double-blind and placebo control.
Setting: University referral centre.
Population: Infertile women undergoing diagnostic laparoscopy with or without additional procedures.
Methods: One hundred and forty-four women were randomised to receive 10 mL of 1% lignocaine at the surgical sites before incision and 10 mL of normal saline before closure of incision (the preemptive group), saline before incision and lignocaine before closure of incision (the preclosure group) and saline at the surgical sites both before incision and closure of incision (the placebo group).
Main outcome measures: Post-operative wound pain measured by linear visual analogue scale and amount of analgesic use.
Results: The women in the preclosure group had significantly lower pain scores at 2, 4 and 24 hours than those in the placebo group, whereas the women in the preemptive group only showed significantly lower pain scores at 2 hours than the placebo group. The pain score at 24 hours in the preclosure group was significantly lower than that in the preemptive group. There was no significant difference in the post-operative analgesic requirement among the three groups.
Conclusion: The preclosure analgesia is better than preemptive analgesia and no analgesia in reducing post-operative wound pain.