In spite of general agreement that pain relief upper abdominal surgery is important for the reduction of postoperative morbidity, the most widely used method remains intramuscular injection or narcotics or non-opioid analgesics with their well
known
disadvantages of respiratory depression, nausea, vomiting and epidural anesthesia and intercostal nerve block are invasive, so do not achieve much popularity.
This double-blind prospective study, 30 patients with subcostal incision performed for cholecystectomy, received 20 ml of either physiologic saline or 0.5% bupivacaine by wound infiltration at the time of closure of the incision. After operation,
pain
score and analgesic requirements were compared at emergence and postoperative 24 hour in each group.
@ES The results were as following;
@EN 1) Mean age of control and bupivacaine group were 45.3(14.9 and 53.6(10.3 yr respectively and mean duration of anesthesia 175(63 and 145(54 minutes respectively.
2) At emergence, mean pain score was 7.7(1.7 in control and 2.7(2.6 in bupivacaine group (p<0.01), and at postoperative 24 hour, mean value of pain score was. 6.8(2.1 in control and 2.3(1.9 in bupivacaine group(p<0.01).
3) At emergence, there were 11 patients(73%) of none to muld pain, 3(20%) of moderate pain and 1(7%) of severe pain in bupivacaine group, whil 0(0%), 6(40%) and 9(60%) respectively in control group. But at postoperative 24 hour, the number of
patients
with none to mild, moderate and severe pain were 13(87%), 2(13%) and 0(0%) in bupivacaine group and 4(27%), 3(20%) and 8(53%) in controi group respectively.
4) In experimental group, patients less than 14% needed additive analgesic, and there were no side reactions in the bupivacaine group.
With above results, we suggest that pouring of 0.5% bupivacaine into incisional wound, especially in cholecystectomy patients, would be a method for postoperative pain relief.
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