Postoperative Pain Relief: The Comparison of Bupivacaine before Incision and Near Closure of Wound
Haq dad Durrani, Rafia Kousar, Ejaz Iqbal, Muhammad Abdul Aziz, Syed Aushtar Abbas Naqvi, Anam Sehrish
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ABSTRACT
Background: Pain is the most common and
most difficult problem faced by patients after operation. Due to inadequate
management 30-70% patients suffer from post-operative pain. Acute pain
resulting in chronic pain reduces quality of life and creates economic burden.
Aim: To compare post-operative
pain relief between infiltration of 0.25% bupivacaine into skin and
subcutaneous tissue in the line of incision before incision and along edges of
wound near completion of procedure.
Study design: Randomized control trial
Methodology: Sixty four patients were
randomly divided into two groups i.e. (0.25% Bupivacaine 6 to 30ml) at the site of incision
into skin and subcutaneous tissue Preincision (Group P) and (0.25% Bupivacaine
6 to 30ml) along the edges of wound at near closure of procedure (Group C).
Intensity of pain was assessed on visual analogue scale in the recovery room,
3, 6 and 24 hours postoperatively.The time of first dose of rescue analgesia within
24 hours was also noted in both groups.
Results: There was no statistically significant difference between two
groups regarding age (p-value = 0.324), gender i.e. males (p=0.545)
females (p=0.763) and duration of operation (P=Value=0.208). The mean time of rescue analgesia in Group P and Group C in
minutes was 318.12±149.47 and 374.84±125.67 respectively (p value =1.5) reflecting
no statistically significant difference.
Conclusion: Postoperative analgesia
and analgesic requirement do not differ significantly whether bupivacaine is
infiltrated before incision or just before closure of wound.
Keywords: Postoperative pain, bupivacaine,
rescue analgesia, Preincision