The role of bupivacaine in decreasing postoperative pain and pulmonary complications

Abstract

We investigated the effectiveness of bupivacaine in 90 selected patients who underwent elective cholecystectomy in controlling postoperative pain. Patients were randomised into 3 groups of 30 patients. In group 1, 50 ml of 0.5 % bupivacaine was injected into the incision layers before closure. In gro¬up 2, a thin epidural catheter was inserted between the peritoneum and the muscle layers. J50 ml of 0.5 % bupivacaine solution was given during the first postoperative 60 hours through an infusion pump. In group 3, 50 ml 0.9 % NaCl was injected into the incision before closure. The three groups were compared usin3g postoperative visual analogue pain score, postoperative need for analgesia, respiratory function and du¬ration of hospital stay. Bupivacaine was more effective than 0.9 % NaCl injection in reducing the need of postoperative pethidine in the first 24 hours after surgery. Median (range) postoperative pethidine dosages were: 60 (20-75) mg in group I; 55 (25-60) ing in group 2 and 100 (20-150) mg in group 3. In later postope¬rative period there was no significant difference. The amount of analgesia required was the same between the groups of injection or infusion of bupivacaine in the first 24 hours (p>0.05). Also there was no signifi¬cant difference in the three groups in respiratory function or duration of hospital stay. Bupivacaine admi¬nistration into the wound could reduce early postoperative pain but had no effect on postoperative reco¬very.