Document Detail

Efficacy of pre-incisional bupivacaine infiltration on postoperative pain relief after appendectomy: prospective double-blind randomized trial.
MedLine Citation:
PMID:  15573244     Owner:  NLM     Status:  MEDLINE    
Pain is the most undesirable and threatening experience for surgical patients. This study aims to determine the efficacy of pre-incisional analgesic bupivacaine infiltration (preemptive analgesia) on postoperative pain relief after appendectomy. A prospective randomized double-blinded study was conducted on 123 patients aged 13-45 years with a preoperative and-postoperative diagnosis of acute appendicitis admitted to Siriraj Hospital, Bangkok, from January to May 2002. They were randomly set into two groups: the control (61 patients) and the preemptive (62 patients). In the preemptive group, bupivacaine (Marcaine) was infiltrated into the skin and subcutaneous tissue along the proposed wound line before gridiron incision, and also into the muscle layer after incision. The control group received no injection. Routine appendectomy was done. Pain score was assessed by the patients in the first 48 hr while they were lying supine and as they moved to a sitting position at 24 and 48 hr after operation. Morphine injection was given on patients' request with pain score = 5 every 4 hr in the first 48 hr or until analgesic paracetamol could be taken orally. The pain score during the first 6, 12, 24, and 48 hr, including the score while sitting up, were all significantly lower ( p < 0.001) in the preemptive group. So were the total number of morphine injections and the amount of morphine used postoperatively. The pain reduction could be due to interruption of inflammatory or pain mediator cascades that normally occur during an operation. This study showed that pre-incisional bupivacaine infiltration is an effective and simple method of reducing postoperative pain for patients undergoing appendectomy.
Varut Lohsiriwat; Narong Lert-akyamanee; Winchai Rushatamukayanunt
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2004-09-29
Journal Detail:
Title:  World journal of surgery     Volume:  28     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-12-01     Completed Date:  2005-02-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  947-50     Citation Subset:  IM    
Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 10700, Bangkok, Thailand.
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MeSH Terms
Anesthetics, Local / administration & dosage*
Appendicitis / surgery
Bupivacaine / administration & dosage*
Double-Blind Method
Pain, Postoperative / prevention & control*
Prospective Studies
Reg. No./Substance:
0/Anesthetics, Local; 2180-92-9/Bupivacaine
Comment In:
World J Surg. 2005 Jul;29(7):936; author reply 936-7   [PMID:  15951951 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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