Rumman Khan, Yousaf Jan, Waqas, Ihsan Ulhaq.
Pre-emptive analgesia: comparison of bupivacaine before incision and after incision among patients undergoing appendicectomy.
Pak J Surg Jan ;30(3):216-21.

Introduction: Pre-emptive analgesia is the administration of an analgesic before a painful stimulus an att empt to obtain bett er pain relief compared with when the same analgesic intervention is used aft er the painful stimulus. Clinical studies have confl icting results regarding the effi cacy of pre-emptive analgesia in patients undergoing appendicectomy. Objective: To compare the mean pain scores between pre incision instillation of bupivacaine with post incision instillation of bupivacaine among patients undergoing appendicectomy. Materials and Methods:Th is randomized controlled study was carried out in surgical unit Hayatabad Medical Complex, Peshawar from Jan 2012 to Jan 2013 aft er taking permission from local ethical and research committ ee. Forty four patients in each group were included in study to compare the eff ectiveness of local infi ltration of bupivacaine before incision (Group A) and aft er incision (Group B) for pain using visual analogue scale control aft er appendicectomy at 24th hour aft er surgery. Data was entered in soft ware SPSS version10.0.T test was used to compare the mean pain scores. Results: Th e mean age of patients in Group A and B was 23.04 years+4.72 and 23.09 years +3.63 respectively(p=0.953). Th e mean pain in Group A and B was 3.1591 + 0.7134 and 3.7500 + 0.943 respectively (p=0.0013). Gender wise (p =0.237) and age wise distribution (p=0.763) of mean pain have insignifi cant diff erence between group A and B. Conclusion: Mean pain score aft er pre incision instillation of bupivacaine is less than its post incision instillation during appendicectomyat 24th hour aft er appendicectomy.

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