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
