Effect of Topical Lignocaine on Postoperative Pain After Laparoscopic Tubal Sterilisation in Awake Patients (Original Article) (Report‪)‬

The introduction of laparoscopic sterilisation resulted in a more than twofold increase in the number of tubal sterilisations. (1) Tubal ligation is a widely accepted method of contraception, in India chosen by 37.3% of women. (2) Initially regional anaesthesia was considered to be safer and produced better surgical results than local anaesthesia. In a retrospective descriptive study conducted on 2 827 cases, laparoscopic tubal ligation with Silastic rings was safely carried out under local anaesthesia with a technical failure rate of 0.14% and a mean operating time of 10 minutes. (3) Tubal ligation is associated with significant pain, both during and after the operation. Tubal rings produce more pain than clips, both during and after occlusion, as ischaemia from occlusion devices releases pain mediators such as prostaglandins. (4,5) In addition to analgesics, local anaesthetics such as lignocaine and bupivacaine have been applied topically as solutions, (6) injected into the mesosalpinx (7) and instilled cervically into the fallopian tubes. (8) However, either these studies were done under general anaesthesia (9) or they were not placebo-controlled and lacked randomisation. (6,10,11)