A study of effectiveness of Local Bupivacaine Infliltration of the wound in Reducing the Post operative parenteral narcotic analgesic requirement

Abstract

To see the effectiveness of lcoal perfusion of the wound with bupivacaine 5% following cholecystectomy was studied. A prospective randomized clinical trail involving 140 patients undergoing cholecystectomy for symptomatic gallstones, using Kocher's incision, was undertaken. Patients were randomizesd to recieve either intermittent intravenous tramadol infusion on demand (parenteral analgesia, PA - group) or wound perfusion with local bupivacaine. 5% per operatively followed by intravenous tramadol infusion, if needed (local analgesia, LA group). On hundred and forty patients were recuruited in the study, 70 in each group. Patient demographics were comparable in the two groups. There was no satistically significant difference in post operative pain scores at rest and with movement between the two groups, excepts median total amount of tramadol used was significantly greater in PA group i.e. 600 (range 0 - 400)mg. Direct local wound perfusion of bupivacaine 0.5% provides good pain relief after cholecystectomy and reduces the requirements of parenteral narcotic analgesia with no major side effect. |in other words it is a safe and feasible alternative to parenteral opiods.