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A study of effectiveness of local bupivacaine infiltration of the wound in reducing the post operative parenteral narcotic analgesic requirement.
Author(s):
1. Zahid Aman: Department of Surgery and Department of Paediatric Surgery, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar, Pakistan
2. Abdul-Qayum: Department of Surgery and Department of Paediatric Surgery, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar, Pakistan
3. Kifayat Khan: Department of Surgery and Department of Paediatric Surgery, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar, Pakistan
Abstract:
To see the effectiveness of local perfusion of the wound with bupivacaine. 5% following cholecystectomy was studied. A prospective randomized clinical trail involving 140 patients undergoing cholecystectomy for symptomatic gallstones, using Kocher’s incision, was undertaken. Patients were randomized to receive either intermittent intravenous tramadol infusion on demand (parenteral analgesia, PA-group) or wound perfusion with local bupivacaine. 5% per-operative following by intravenous tramadol infusion, if needed (local analgesia, LA-group). One hundred and forty patients were recruited in the study, 70 in each group. Patients demographics were comparable in the two groups. There was no statistically significant difference in post-operative pain scores at rest and with movement between the two groups, excepts for pain scores at rest on the first post-operative day (P=0.03). The median total amount of tramadol used was significantly greater in PA group i.e. 600 (range 500-1000)mg as compared to the amount used in LA-group i.e. 200 (range 0-400) mg. Direct local wound perfusion of bupivacaine 0.5% provides good pain relief after cholecystectomy and reduces the requirements of parenteral narcotic analgesia with no major side effect. In other words it is a safe and feasible alternative to parenteral opiods.
Page(s): 7-11
DOI: DOI not available
Published: Journal: Journal of Postgraduate Medical Institute, Volume: 18, Issue: 1, Year: 2004
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