EFFECT OF BUPIVACAINE INFILTRATION ON POSTOPERATIVE PAIN SCORE

ABSTRACT
Objective: Adequate pain relief is vital for early recovery and mobilization after surgery. The purpose of our study was
to compare the two groups after open cholecystectomy in terms of the effect of long acting local anesthetic agent
(Bupivacaine) infiltration on postoperative pain score.
Material And Method: This randomized controlled trial was conducted in the surgical units of Khyber Teaching Hospital,
Peshawar from 1st January 2014 to 31st December 2014. The study excluded patients in ASA III or above, patients with
acute complicated cholecystitis. 0.25% Bupivacaine 2ml/kg body weight was infiltrated into the incision at the time of
wound closure in group A. Postoperative pain was assessed by Visual Analogue Scale (VAS). Patients were asked
about the intensity of their pain 4 hours, 8hours, 12 and 24 hours after surgeryon a Visual Analogue Scale. Total dose
and timing of first injection of Tramadol were recorded. Data was entered on a structured proforma and analyzed on
SPSS version 20. P value of less than 0.05 was considered significant.
Result: The study included 100 patients. 50 patients in group A (Bupivacaine infiltration group) and 50 in group B
(control group).There was statistically significant difference between the two groups in postoperative pain score at 4, 8
and 12 hours after surgery but not at 24 hours. VAS score at 4 hours was 2.3 in group A and 3.6 in group B, at 8 hours
2.5 in group A and 3.9 in group B, at 12 hours 2.2 in group A and 3.8 in group B, at 24 hours 4 in group A and 4.2 in
group B. Time to first injection of Tramadol was 10 hours in group A while 4 hours in group B.
Conclusion: Infiltration of Bupivacaine into the incision at the time of wound closure provides effective postoperative
analgesia and should be used routinely.
Keywords: Postoperative pain, Cholecystectomy, Bupivacaine, Local anesthetic.