Pre-incisional versus post-incisional wound infiltration of bupivacaine for post-operative analgesia in abdominal procedures: a comparative analysis

Santosh Kumar Tiwari*, Abhaychandra Srivastav, Chandrashekhar Azad

NSB District Hospital Gorakhpur, Uttar Pradesh, India

ABSTRACT

Abdominal procedures are widespread all around the world, with varying post-operative results. Subjects, surgeons, and anesthetists all worry about post-operative discomfort. Because of their extended duration of action, bupivacaine and ropivacaine are extensively used local anesthetics in wound infiltration. We compared pre-incisional and post-incisional bupivacaine wound infiltration for post-operative pain management in abdominal operations in this research. The research was a hospital-based comparative, interventional research that included subjects aged 19 to 50 years old, of either gender, who were undergoing elective lower abdominal procedures lasting less than 2 hours under general anesthesia and were willing to take part in the research. In this research, 120 subjects were allocated into two categories at random (category A and category B). Age (in years), gender (male/female), weight (in kgs), height (in c.m), and ASA status (I/II) were all comparable in both categories, with no statistically significant differences. Operative characteristics such as operative duration (in minutes) and incision length (in c.m) were comparable in both categories, whereas the time for the first rescue dose (in minutes) and the number of rescue doses in the post-operative 24 hours were better in the pre-incisional category compared to the post-incisional category, with the difference being statistically significant. The VAS score in the pre-incisional category was lower than the post-incisional category at 4, 8, 12, 18, and 24 hours after surgical intervention, and the difference was statistically significant. Pre-incisional wound infiltration had better postoperative analgesia, as judged by the VAS, than the post-incisional category wound infiltration.

Keywords:

Bupivacaine, Post-operative pain, Visual analog scale.