Preoperative infiltration of bupivacaine - effects on pain relief and trauma response (cortisol and interleukin-6)

Hypothesis: Subcutaneous infiltration of bupivacaine before skin incision can reduce postoperative pain and modulate the stress response. Methods: In a randomized study on pain relief after hysterectomy 29 patients were referred into one of three groups, receiving 30 ml of bupivacaine 0.25% with adr...

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Bibliographic Details
Published in:Acta anaesthesiologica Scandinavica 1997-04, Vol.41 (4), p.466-472
Main Authors: ERIKSSON-MJOBERG, M., KRISTIANSSON, M., CARLSTROM, K., EKLUND, J., GUSTAFSSON, L. L., ÖLUND, A.
Format: Article
Language:English
Subjects:
Adult
Analgesia, Patient-Controlled
Analgesics: morphine
Anesthetics, Local - administration & dosage
Anesthetics. Neuromuscular blocking agents
Biological and medical sciences
bupivacaine
Bupivacaine - administration & dosage
Humans
Hydrocortisone - blood
Interleukin-6 - blood
local analgesics
Medical sciences
Medicin och hälsovetenskap
Middle Aged
morphine
Morphine - administration & dosage
Neuropharmacology
pain prevention
Pain, Postoperative - prevention & control
PCA
Pharmacology. Drug treatments
postoperative pain
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Summary:Hypothesis: Subcutaneous infiltration of bupivacaine before skin incision can reduce postoperative pain and modulate the stress response. Methods: In a randomized study on pain relief after hysterectomy 29 patients were referred into one of three groups, receiving 30 ml of bupivacaine 0.25% with adrenaline, 30 ml of saline or no infiltration along the line of the proposed incision 10 min before start of surgery. A Visual Analogue Scale was used for repeated pain ratings. Postoperative pain relief was provided with patient‐controlled analgesia with intravenous morphine 0.04 mg/kg. Lockout time was 10 min. The immuno‐logical and endocrine stress response to trauma was reflected by blood interleukin‐6 (IL‐6) and cortisol concentrations measured during 72 h following skin incision. Results: There were large individual variations in the accumulated postoperative consumption of morphine at 20 h after start of surgery. It was significantly reduced in patients receiving infiltration of bupivacaine. They used 39 mg (9–62) median (range) of intravenous morphine whereas the patients in the saline group used 65 mg (47–120) and patients in the control group used 54 mg (36–130) (P
ISSN:0001-5172
1399-6576
DOI:10.1111/j.1399-6576.1997.tb04725.x