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Levobupivacaine intravesical injection for superficial bladder tumor resection--possible, effective, and durable. Preliminary clinical data.

Abstract：

BACKGROUND:General and spinal anesthesia are currently in widespread use during transurethral bladder tumor resection. However, local anesthetic methods are claimed to provide sufficient intra-operative analgesia and satisfactory post-operative pain management. We evaluated whether local levobupivacaine infiltration of the tumor would result in outcomes, in terms of intra-operative analgesia, similar to those for utilization of general anesthesia. Post-operative analgesia and patient satisfaction were also assessed. PATIENTS AND METHODS:Twenty patients with recurrent solitary bladder tumors were randomly allocated in two groups. Group A, underwent tumor resection under general anesthesia and group B was treated with resection after local levobupivacaine infiltration. Post-operative analgesia was evaluated with utilization of a visual analogue scale, ranging from 0 to 10, with higher scores indicating more intense pain perception. RESULTS:Group A patients demonstrated significantly lower visual analogue scale scores at t=0, which peaked at 4 h post-operatively. Group B scores were higher at t=0, declined over a 2 h interval and reached zero after t=4 h. Patients younger than 60 years and women benefitted more. Local anaesthesia was the method of pain control preferred by 90% of patients. CONCLUSION:Local levobupivacaine infiltration for transurethral bladder tumor resection seems feasible, providing intra and post-operative pain control. In this preliminary setting, general anesthesia provided a higher level of pain control in the immediate post-operative period (<4 h) while local levobupivacaine infiltration demonstrated excellent late post-operative analgesia (>4 h). Also, patients seem to prefer local to general anesthesia in future surgery.

journal_name

Int Urol Nephrol

journal_title

International urology and nephrology

authors

Stravodimos KG,Mitropoulos D,Salvari A,Lampadariou A,Kapetanakis T,Zervas A

doi

10.1007/s11255-007-9295-6

subject

Has Abstract

pub_date

2008-01-01 00:00:00

pages

637-41

issue

eissn

0301-1623

issn

1573-2584

journal_volume

pub_type

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Levobupivacaine intravesical injection for superficial bladder tumor resection--possible, effective, and durable. Preliminary clinical data.