Nadhima Hh Al Hakim, Zahra S Alidreesi.
The effect of local anaesthetic wound infiltration on post-operative pain after cesarean section.
J Surg Pak Jan ;15(3):131-4.

Objective To find out the effect of local anaesthetic (bupivacaine) wound infiltration before skin wound closure on postoperative use of opioids after elective lower segment caesarean section. Study design A randomized clinical trial. Place & Duration of study Department of Obstetrics & Gynecology, Delma hospital WMR, UAE, from March 2007 till May 2009. Methodology Thirty patients were assigned randomly to receive either 20ml of 0.5% bupivacaine or 20ml normal saline solution (group A - placebo group) that was injected in the subcuticular tissue and fascia before closure of the skin. Pethidine consumption was measured during the postoperative period till 24 hours. Postoperative pain was assessed at 30 minutes, and 2, 4, 6, 12 and 24 hours after operation with a visual analog scale (VAS). Data were analyzed by the student t-test Results The two treatment groups were treated by the same physicians and all had elective lower segment caesarean sections via Pfannenstiel incision. There was a decrease in opioid consumption and pain on visual analog scale in the group B that received local anaesthesia, as compared with the placebo group. (group A). The total consumption of pethidin between the groups was 113 mg versus 73.3mg (p < 0.05). Conclusion Pre-emptive analgesia with 20ml of 0.5% bupivacaine infiltrated before closure of the skin decreased postoperative analgesia request with pethidine in patients who underwent elective lower segment caesarean section by Pfannenstiel incision.

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