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Efficacy of submucosal bupivacaine injection for pain relief after endoscopic submucosal dissection: A multicenter, prospective, randomized controlled, and double-blind trial.

Abstract：

BACKGROUND AND AIM:Although abdominal pain is a common adverse event related to endoscopic submucosal dissection (ESD), it can be sometimes underestimated by endoscopists. There are some endoscopic interventions available for the prevention of post-ESD pain, but their efficacy has not been established. We investigated whether a submucosal injection of bupivacaine (BP) can reduce procedure-related abdominal pain compared with the standard method. METHODS:We performed a multicenter, double-blinded, randomized controlled trial of 86 adult patients referred for ESD as treatment for gastric neoplasms. Patients were randomly assigned to either the BP submucosal or conventional solution group. Questionnaires were collected when the study began (baseline) and immediately after ESD, as well as at 6, 12, and 24 hours post-operatively. The primary outcome was indicated by the visual analog scale (VAS) evaluated at 6 hours after procedure. RESULTS:There were no significant differences in primary outcomes between groups and among all time points (immediately, 12, and 24 hours after ESD). The VAS and short-form McGill pain (SF-MP) scores were higher immediately after ESD than at 6, 12, or 24 hours post-operatively. The incidence of abdominal pain immediately after ESD was 94.0% (78/83) for all patients of both groups, and there was no significant difference between the 2 groups in the rate of abdominal pain immediately after ESD (BP group 37/40 [92.5%] versus non-BP group 41/43 [95.3%], P = .934). In univariable and multivariable analyses, BP did not have protective effect on post-ESD abdominal pain. CONCLUSIONS:Submucosal BP injection does not promote pain relief or mitigate the effects of post-ESD abdominal pain.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Jung JH,Jang HJ,Bang CS,Baik GH,Park SW

doi

10.1097/MD.0000000000015360

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

e15360

issue

eissn

0025-7974

issn

1536-5964

pii

00005792-201904260-00071

journal_volume

pub_type

杂志文章,多中心研究,随机对照试验

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Efficacy of submucosal bupivacaine injection for pain relief after endoscopic submucosal dissection: A multicenter, prospective, randomized controlled, and double-blind trial.