Analgesic Efficacy of Ropivacaine-P407 Gel vs. Bupivacaine in Single-Port–Assisted Hysterectomy: A Propensity Score–Matched Analysis
- 1Department of Obstetrics and Gynecology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea .
- 2Department of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, Korea .
Abstract
Purpose: To compare the postoperative analgesic efficacy of ropivacaine-poloxamer 407 (P407) gel injection with that of bupivacaine injection in patients undergoing single-port assisted hysterectomy.
Materials and Methods: This retrospective study reviewed medical records from January to December 2023 at Severance Hospital, Yonsei University. A total of 209 patients undergoing minimally invasive hysterectomy with or without adnexal procedures were analyzed. Patients were divided into two groups: 42 received ropivacaine-P407 gel (Welpass), and 167 received bupivacaine alone. Demographic variables, intraoperative parameters, and postoperative pain scores were collected. Propensity score matching was applied to control for surgical complexity and baseline imbalances, yielding 31 matched pairs. Pain levels were assessed using the Numeric Rating Scale (NRS) at multiple time points up to 48 hours postoperatively.
Results: Before matching, the ropivacaine-P407 gel group demonstrated significantly lower pain scores starting at 12 hours postoperatively compared to the bupivacaine group (NRS difference p=0.005 at 24 hours, p=0.020 at 48 hours). After propensity score matching, this difference remained significant: patients in the ropivacaine-P407 gel group continued to report reduced pain intensity at 24 hours [mean NRS±standard deviation (SD): 1.96±0.35 vs. 2.86±1.35, p=0.003] and 48 hours (1.88±0.49 vs. 2.65±1.12, p=0.014). Both groups showed similar safety profiles, with no severe adverse reactions related to the anesthetic agents reported.
Conclusion: Ropivacaine-P407 gel injection provides superior early postoperative analgesia compared to bupivacaine alone in minimally invasive hysterectomy.
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BibTeX
@article{kim2026analgesic,
title = {{Analgesic Efficacy of Ropivacaine-P407 Gel vs. Bupivacaine in Single-Port–Assisted Hysterectomy: A Propensity Score–Matched Analysis}},
author = {Jung Chul Kim and Yong Jae Lee and Eun Ji Nam and Sunghoon Kim and Jung-Yun Lee and Young Tae Kim and Sang Wun Kim},
journal = {Yonsei Medical Journal},
year = {2026},
month = sep,
doi = {10.3349/ymj.2025.0393},
url = {https://doi.org/10.3349/ymj.2025.0393},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Analgesic Efficacy of Ropivacaine-P407 Gel vs. Bupivacaine in Single-Port–Assisted Hysterectomy: A Propensity Score–Matched Analysis
AU - Jung Chul Kim
AU - Yong Jae Lee
AU - Eun Ji Nam
AU - Sunghoon Kim
AU - Jung-Yun Lee
AU - Young Tae Kim
AU - Sang Wun Kim
PY - 2026
DA - 2026/09/14
JO - Yonsei Medical Journal
DO - 10.3349/ymj.2025.0393
UR - https://doi.org/10.3349/ymj.2025.0393
AB - Purpose: To compare the postoperative analgesic efficacy of ropivacaine-poloxamer 407 (P407) gel injection with that of bupivacaine injection in patients undergoing single-port assisted hysterectomy. Materials and Methods: This retrospective study reviewed medical records from January to December 2023 at Severance Hospital, Yonsei University. A total of 209 patients undergoing minimally invasive hysterectomy with or without adnexal procedures were analyzed. Patients were divided into two groups: 42 received ropivacaine-P407 gel (Welpass), and 167 received bupivacaine alone. Demographic variables, intraoperative parameters, and postoperative pain scores were collected. Propensity score matching was applied to control for surgical complexity and baseline imbalances, yielding 31 matched pairs. Pain levels were assessed using the Numeric Rating Scale (NRS) at multiple time points up to 48 hours postoperatively. Results: Before matching, the ropivacaine-P407 gel group demonstrated significantly lower pain scores starting at 12 hours postoperatively compared to the bupivacaine group (NRS difference p=0.005 at 24 hours, p=0.020 at 48 hours). After propensity score matching, this difference remained significant: patients in the ropivacaine-P407 gel group continued to report reduced pain intensity at 24 hours [mean NRS±standard deviation (SD): 1.96±0.35 vs. 2.86±1.35, p=0.003] and 48 hours (1.88±0.49 vs. 2.65±1.12, p=0.014). Both groups showed similar safety profiles, with no severe adverse reactions related to the anesthetic agents reported. Conclusion: Ropivacaine-P407 gel injection provides superior early postoperative analgesia compared to bupivacaine alone in minimally invasive hysterectomy.
SN - 0513-5796
SN - 1976-2437
ER -