Samreen Amin, Shagufta Tahir.
Impact of bupivacaine infiltration of postoperative wound on parenteral narcotic analgesic requirement for pain.
J Surg Pak Jan ;15(4):177-81.

Objective To compare the postoperative pain scores and amount of parenteral analgesia (tramadol) used in patients receiving local infiltration of bupivacaine, of surgical wound for caesarean section with patients not receiving local infiltration for the same procedure. Study design Comparative study. Place & Duration of study Department of Obstetrics & Gynaecology at Liaquat National Medical College & Hospital, Karachi, from May 2005 to 2006. Methodology The study included a total of 100 patients undergoing caesarean section. They were divided into two groups of 50 patients each. Study group received local bupivacaine infiltration and in control group no local infiltration was done. Results There was no significant difference in demographic data, post-operative pain on visual analogue pain scores at rest and with movement between the two groups except for pain score at rest after 12 hours (p 0.020). However, tramadol requirement to produce pain relief was significantly less in patients of study group as compared to control group and on first postoperative day (p 0.070). Cumulative milligrams of tramadol used were 95.0 versus 151.0 at 12 hours, 98.0 versus 225.0 at first postoperative day and 52.0 versus 127.0 at second postoperative day for study and control group respectively (p <0.001). Conclusions Direct local wound infiltration of bupivacaine provided good pain relief after caesarean section and reduced the requirement of parenteral narcotic analgesia with no major side-effects.

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