Effect of preincision versus postincision infiltration with bupivacaine on postoperative pain.

Abstract

STUDY OBJECTIVE:

To compare the efficacy of preincision wound infiltration with bupivacaine to wound infiltration at the end of the operation.

DESIGN:

A prospective, randomized, double-blind study.

SETTING:

University medical center.

PATIENTS:

56 ASA status I and II women scheduled for abdominal hysterectomy were randomly assigned to one of three treatment groups.

INTERVENTIONS:

Group 1 (control) received no local anesthetic infiltration. Group 2 received subcutaneous infiltration with 40 ml of bupivacaine 0.5% (pH 6.9) 15 minutes prior to incision. Group 3 received wound infiltration with a similar solution at the end of surgery. Anesthesia was induced with thiopental 3.0 mg/kg i.v., droperidol 50 micrograms/kg i.v., and sufentanil 0.5 microgram/kg i.v. and maintained with nitrous oxide 67% in oxygen and sufentanil 0.1 microgram/kg IV boluses as required. Postoperative pain was treated with morphine via a patient-controlled analgesia delivery system for 24 hours, followed by oral hydrocodone for 3 days.

MEASUREMENTS AND MAIN RESULTS:

The opioid consumption was recorded for 4 days postoperatively. Pain scores were measured at 4 to 8-hour intervals using 100 mm visual analog scales. There was no difference in either the opioid analgesic requirements or the pain scores between the three study groups.

CONCLUSIONS:

Wound infiltration, either preincision or postincision, had no clinically significant effect on the pain scores or analgesic requirements following abdominal hysterectomy.

• Authors: R A Victory, N M Gajraj, A Van Elstraete, N A Pace, E R Johnson, P F White
• Journal: Journal of clinical anesthesia (J Clin Anesth) Vol. 7 Issue 3 Pg. 192-6 (May 1995) ISSN: 0952-8180 [Print] United States
• PMID: 7669307 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Bupivacaine

Topics

• Adult
• Bupivacaine (therapeutic use)
• Double-Blind Method
• Drug Administration Schedule
• Female
• Humans
• Middle Aged
• Pain, Postoperative (prevention & control)
• Postoperative Care
• Premedication
• Prospective Studies