Effects of local infiltration of bupivacaine in total hip and knee replacement for post-operative analgesia

الملخص EN

Background: Pain is one of the most postoperative complications of surgical wound especially within first 24 hrs.

leading to delay hospital discharge, stress gastritis and increasing blood pressure.

As wound infiltration with long acting local anesthetic (bupivacaine) has been proved to be effective after orthopedic surgeries especially total hip and knee replacements.

Objective: our study was designed to determine the effectiveness of local infiltration of 0.5% of bupivacaine before closure of surgical wounds in controlling postoperative pain and improve patient’s outcome after total hip and knee replacement surgeries in first 24hrs postoperative period.

Methods: Twenty patients from class I (healthy patients) and class II (patients mild systemic diseases) of ASA (American society of anesthetists) undergoing elective orthopaedic surgeries were randomly assigned in two groups and (both of them have general anesthesia); Group A (10patients) received local infiltration of 0.5% bupivacaine before closure of surgical wounds and group B (10 patients) received local infiltration of 0.9% of normal saline.

We use uniform technique of anesthesia in both at rest and on passive mobilization by nurses and residents groups.

Visual analogue pain scale scores were assessed blinded to analgesic treatment and we check the needs for analgesic drugs post-operative in both groups.

Results: Group A showed a significant reduction in postoperative pain at rest and on mobilization after infiltration of 0.5% bupivacaine with short hospital stay and only 3 patients need for post-operative analgesia ,while all patients in group B require at least single dose of analgesia like pethidine or non-steroidal anti-inflammatory drugs.

Conclusion: The use of 0.5% Bupivacaine by wound infiltration is effective for post-operative pain relief, as it reduces the requirements for additional post-operative analgesia after total hip and knee replacements.