Title : Which to choose pre incisional or post incisional bupivacaine for pain relief in patients undergoing elective surgery
Abstract:
Background:
Pain is the most important concern after surgical intervention that needs to be addressed for better compliance and early mobilization to avoid complications. The need of better analgesic and timings of its administration is the key to success.
Objective:
To compare the mean post-operative pain score with pre incisional versus post-operative injection of bupivacaine in patients undergoing elective surgery.
Method:
Patients Age between 18-60 years undergoing elective surgery were studied, they were divided into two groups. The cases in group A were given pre incision bupivacaine and group B with postoperative bupivacaine and were assessed at 1 hour after surgery regarding pain on VAS.
Inclusion criteria:
- Patients of both genders with ages in the range of 18-60 years undergoing elective surgery.
- Patients who sign written informed consent.
Exclusion criteria:
- Allergy to bupivacaine, Steroid intake.
- Deranged coagulation profile
- ASA Class ≥III
Results:
Studied participants were 64 cases equally divided between two groups (32 in each group) There were 19 (59.37%) males in group A vs 18 (56.25%) in group B. The mean age of 47.56±7.51 years in the group A and 49.13±8.03 years in group B.
The mean post-operative pain in group A was 3.07±0.67 vs 3.59±0.91 in group B on VAS with p= 0.03. Mean post-operative pain in males was 3.12±0.65 vs 3.47±0.86 and in females it was 3.21±0.66 vs3.53±0.90 in group A and B with p values of 0.21 and 0.23 respectively. Mean Post-operative pain was 3.11±0.66 vs 3.44±0.83 in age group 18-39 years and 3.08±0.68 vs 3.47±0.88 in age group 40 to 60 years in group A and B with p values of 0.25 and 0.20 respectively. There was significant difference in terms of post-operative pain in cases undergoing open surgery with pre- incisional Bupivacaine.
Conclusion:
Post-operative pain is significantly better in cases treated with pre- incision bupivacaine as compared to post-operative bupivacaine and this difference was significant in cases undergoing open Surgery.
