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Effect of Preventive Analgesia by Injection of a Local Anesthetic Before Vaginal Incision for Hysterectomy by vNOTES Approach

Phase 3
Not yet recruiting
Conditions
Hysterotomy; Affecting Fetus
Interventions
Other: questionnaires
Drug: Naropeine
Other: Placebo
Registration Number
NCT05969457
Lead Sponsor
University Hospital, Rouen
Brief Summary

The research procedure is the injection of 20 mL of Ropivacaine solution (vs. saline) to create a paracervical block at the beginning of surgery, while the patient is already under general anesthesia.

This injection will take place 3 minutes before the vaginal incision, via 4 injection points. Injections are made 3 mm deep into the vaginal cul de sac.

Randomization takes place before surgery by vNOTES:

* Experienced group: Local anesthesia with injection of Ropivacaine (20mL of ropivacaine 7.5 mg/mL, i.e. 150mg) and general anesthesia

* Control group: Injection of 20mL of placebo (saline) and general anesthesia

In both groups, systematic intraoperative and postoperative analgesia will be identical.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
Female
Target Recruitment
108
Inclusion Criteria
  • Adult patients aged 18 to 70 inclusive
  • Patient scheduled for vNOTES surgery for total hysterectomy for benign pathology, whether or not associated with an adnexal procedure (unilateral or bilateral salpingectomy or adnexectomy (for cysts smaller than 6 cm)).
  • Person having read and understood the information letter and signed the consent form
  • Person affiliated to a social security scheme
Exclusion Criteria
  • Suspicion of malignant pathology
  • History of rectal surgery
  • History of pelvic inflammatory disease
  • Suspicion of recto-vaginal endometriosis
  • Virginity
  • Contraindication to NAROPEINE 7.5 mg/mL, solution for injection in ampoule
  • Contraindication to PROAMP SODIUM CHLORIDE 0.9%, solution for injection
  • Patients on a low-salt diet
  • History of more than 2 caesarean sections
  • Estimated uterine size > 700 g according to the following formula y = 0.35x + 107 (x = a × b × c), based on measurements taken on preoperative imaging (MRI or ultrasound). a=longitudinal diameter, b=sagital diameter, c=transverse diameter.3
  • BMI > 35
  • Contraindication to analgesic molecules in intraoperative and postoperative protocols.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Control groupquestionnairesAdministration of a saline solution
Control groupPlaceboAdministration of a saline solution
Experienced groupNaropeineAdministration of Naropeine
Experienced groupquestionnairesAdministration of Naropeine
Primary Outcome Measures
NameTimeMethod
pain after surgery4hours after surgery

Pain will be assessed by the post-operative hospital nurse using a numerical rating scale (NRS) NRS score from 1 to 10 -\> 10 correspoding to the worst pain

Secondary Outcome Measures
NameTimeMethod
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