Comparison of Mean Post-Operative Pain Score with Pre-Incisional Versus Postoperative Injection of Bupivacaine in Patients Undergoing Elective Surgery.

The most important concern after the surgical intervention is pain which needs to be addressed for better compliance and early mobilization to avoid other complications. The need for a better analgesic and time of administration is the key to success.

Objective: To compare the mean post-operative pain score with pre-incisional versus post-operative injection of bupivacaine in patients undergoing elective surgery.

Study design: This Randomized controlled trial was conducted in the General surgery department, National Hospital & Medical Centre, Lahore from 24-02-20 to 24-11-20. Data was collected through Non-probability consecutive sampling. The cases of both genders with an age range of 18-60 years undergoing elective surgeries were selected. They were divided into two groups. The cases in group A were given pre-incision bupivacaine and group B with post-operative bupivacaine and were assessed 1 hour after surgery regarding pain on VAS.

Results: In the present study there were a total of 64 cases with 32 in each group. The mean age in group A was 47.56±7.51 years while in group B was 49.13±8.03 years. There were 19 (59.37%) males in group A vs 18 (56.25%) in group B. The mean post-operative pain in group A was 3.07±0.67 vs 3.59±0.91 in group B on VAS with p= 0.03. Mean post-operative pain in males was 3.12±0.65 vs 3.47±0.86 and in females, it was 3.21±0.66 vs 3.53±0.90 in groups A and B with p values of 0.21 and 0.23 respectively. Mean Post-operative pain was 3.11±0.66 vs 3.44±0.83 in the age group 18-39 years and 3.08±0.68 vs 3.47±0.88 in age group 40 to 60 years in group A and B with p values of 0.25 and 0.20 respectively. There was a significant difference in terms of postoperative pain in cases undergoing open cholecystectomy where pain was 3.21±0.78 vs 3.86±1.02 in group A and B respectively with p= 0.01. Whereas no difference was seen in the rest of the variables.

Conclusion: Mean post-operative pain is significantly better in cases treated with pre-incisional bupivacaine as compared to post-operative bupivacaine and this difference was also seen as significantly high in cases undergoing open cholecystectomy.