Intra-operative Uterosacral Ligament Bupivacaine Injection During Minimally Invasive Hysterectomy

The Effect of Intra-operative Uterosacral Bupivacaine Injection on Post-operative Pain in Patients Undergoing Minimally Invasive Hysterectomy

This is proof of concept, phase I randomized controlled trial studying a short acting non-opioid anesthetic, bupivacaine to improve post-operative pain in gynecologic surgery patients. Patients who are undergoing minimally invasive (laparoscopic or robotic) hysterectomy will be randomized to receive no uterosacral injection, normal saline uterosacral injection, or 0.25% bupivacaine uterosacral injection just prior to colpotomy (incision around the cervix and removal of uterus) during minimally invasive hysterectomy.

Inclusion Criteria:

• Women over the age of 18 years old
• undergoing benign minimally invasive hysterectomy with minimally invasive GYN surgeon at Johns Hopkins Hospital
• Patients must be English speaking.

Exclusion Criteria:

• Pregnancy
• allergy, contraindication, or intolerance to bupivacaine, opioids, Tylenol, or NSAID drugs
• pre-operative daily opioid consumption
• peri-operative transverse abdominis plane block
• recent history of drug or alcohol abuse (in last year)
• severe cardiovascular, hepatic or renal disease.