Document Detail


Wound infiltration with 0.25% bupivacaine not effective for postoperative analgesia after cholecystectomy.
MedLine Citation:
PMID:  1867617     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The instillation of local anaesthetic agents into surgical wounds has been reported to be an effective method of reducing pain and narcotic requirements, using both local injection and topical application techniques. We performed a double-blind trial to test the value of the long-acting local anaesthetic, bupivacaine, in this role. Eighty patients undergoing elective cholecystectomy were entered into the study. They were divided into 2 groups of 40 patients to compare a local injection technique with a topical application technique. For each route of application, 20 patients received a test solution containing 0.25% plain bupivacaine, and 20 received 0.9% NaCl as a control. Postoperative analgesia in the form of intramuscular pethidine (1-1.5 mg/kg) was made available to all patients on request. The degree of postoperative pain was assessed using three criteria: the time from operation to the first request for analgesia, the total dose of postoperative pethidine required during the first 3 postoperative days and the patient's rating of pain on a 10 cm linear analogue scale at 24 h and 72 h. There was no statistically significant difference between the degree of postoperative pain experienced by patients receiving bupivacaine and those receiving NaCl, when assessed by any criterion. There was also no significant difference found between patients receiving bupivacaine by local infiltration and those receiving the drug topically. It is concluded that the local application of bupivacaine to the wound is not an effective analgesic technique following laparotomy for cholecystectomy.
Authors:
W J Adams; J Avramovic; B H Barraclough
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Australian and New Zealand journal of surgery     Volume:  61     ISSN:  0004-8682     ISO Abbreviation:  Aust N Z J Surg     Publication Date:  1991 Aug 
Date Detail:
Created Date:  1991-09-06     Completed Date:  1991-09-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0373115     Medline TA:  Aust N Z J Surg     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  626-30     Citation Subset:  IM    
Affiliation:
Department of Surgery, Westmead Hospital, New South Wales, Australia.
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MeSH Terms
Descriptor/Qualifier:
Administration, Cutaneous
Adult
Aged
Aged, 80 and over
Bupivacaine / administration & dosage,  therapeutic use*
Cholecystectomy* / adverse effects
Double-Blind Method
Female
Humans
Injections, Intradermal
Injections, Intralesional
Injections, Intramuscular
Injections, Intraperitoneal
Laparotomy / adverse effects
Male
Meperidine / administration & dosage,  therapeutic use
Middle Aged
Pain Measurement
Pain, Postoperative / prevention & control*
Chemical
Reg. No./Substance:
2180-92-9/Bupivacaine; 57-42-1/Meperidine

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


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