A Comparative Study between the Efficacy of Pre-incisional and Post-incisional Wound Infiltration of Bupivacaine for the Relief of Post-operative Pain

Abstract

Introduction: Pain, the “fifth vital sign” is an unpleasant sensation localized to a part of the body. Post-operative pain has been widely studied, as it causes adverse psychological and physiological effects. Many anesthetic agents and techniques have been developed to minimize the post-operative pain. This study compares the effectiveness of two such techniques: Pre-incisional and post-incisional infiltration using bupivacaine as the anesthetic agent.
Materials and Methods: This prospective, randomized, non-crossover type, double-blind interventional study was conducted on 60 patients of either gender, aged 15–50 years, belonging to the American Society of Anesthesiologists Grades I and II undergoing lower abdominal surgeries. They were randomly divided into two groups: Pre-incisional and post-incisional infiltration groups and were monitored for up to 24 h postoperatively for the duration of analgesia and intensity of pain.
Results: The duration of post-operative analgesia was better in the pre-incisional infiltration group (540 min) compared to the post-incisional infiltration group (360 min). Similarly, the overall mean pulse rate, mean systolic blood pressure (SBP), and mean respiratory rate were lower in the pre-incisional infiltration group, indicating better post-operative pain relief.
Conclusion: Although both pre-incisional and post-incisional infiltration of bupivacaine are safe, pre-incisional infiltration provides better relief of post-operative pain.