Recovery quality after periumbilical infiltration with liposomal bupivacaine vs ropivacaine in gynecologic single-port laparoscopic surgery, a double blind randomized controlled trial.

OBJECTIVE: This study aimed tocompareliposomal bupivacainewithropivacaine for periumbilical infiltration in enhancing recovery quality after gynecologic single-port laparoscopic surgery. METHODS: In this prospective, randomized, double-blind clinical trial, 80 patients undergoing elective gynecologic SPLS were randomly allocated to receive periumbilical infiltration with either 20 mL of 266 mg liposomal bupivacaine (LB group, n = 40) or 20 mL of 0.2 % ropivacaine (RO group, n = 40). The primary outcome was the Quality of Recovery-15 (QoR-15) score at 48 h postoperatively. Secondary outcomes included postoperative pain scores at rest and during ambulation, opioid consumption, use of rescue non-opioid analgesia, and incidence of adverse events. RESULTS: The median QoR-15 score at 48 h was not significantly different between the LB and RO groups (127 [IQR 105.25-134.5] vs. 117 [104-128.75]; median difference, 4; 95 % CI, -3 to 12; P = 0.285). No significant differences were observed in pain scores (Numerical Rating Scale, NRS) at rest or during ambulation, or in total opioid consumption (P = 0.181). However, the use of rescue diclofenac sodium suppositories was significantly lower in the LB group on postoperative day 0 (P < 0.001) and overall (P = 0.007). The safety profile was comparable between groups. CONCLUSION: In patients undergoing gynecologic single-port laparoscopic surgery within a multimodal analgesic regimen, umbilical infiltration with liposomal bupivacaine did not improve the quality of recovery at 48 h, postoperative pain scores, or opioid consumption compared to ropivacaine.