Incisional local anesthesia for pain control after abdominal surgery

Abstract EN

Bach ground : -The optimizing of postoperative pain control is an important aspect in perioperative patient care the use of inscional local anaesthesia in post-operative pain control after abdominal operations was proved effective method of analgesia Aim:-to evaluate the efficacy of postoperative incisional infusion of local anaesthesia (bupivicain) in reduction of postoperative pain in abdominal surgical wounds as well as the need for systemic analgesia and possible side effects of local anaesthesia.

Patients and Method : - aprospective randomized placebo controlled clinical trial on 80 patients (39 male 41 female) between 13–54 years old of different abdominal operations, admitted to El- furat hospital in kufa city from December 2005 to October 2006.

The patients were divided in two groups, intervention group 40 patients and placebo group : 40 patients.

The study involve the use of incisional intermittent injection of local anesthesia bupivacaine 0.25% via thin subfascial catheter ( B / BRAUN Melsungen AG), in intervention group, for relieve of postoperative pain and assess need for systemic analgesia ( especially opiate) as compared to placebo group in which we inject normal saline via the incisional catheter.

Result : -The study had been discusses age, sex distribution, types of incision, pain assessment by visual analogue score, the need for systemic analgesia & complications of local anesthesia.

The mean visual analogue score of pain was measured in 1st 6th, 12th , 18th , 24th hours after surgery in every patient in both groups were significantly decreased in bupivacaine group in comparism to normal saline group P<0.005.

There is significant decrease for systemic analgesia requirements after operation in intervention group as compared with placebo group (P<0.05).

There is only one minor complication (seroma or wound infection) was reported in each group (2.5%).

Conclusion : -Study concludes the effectiveness of incisional bupivacaine intermittent injection in relieve of postoperative pain and decrease need for systemic analgesia.