Postoperative Analgesic Effect of Wound Site Infiltration with Bupivacaine versus Ropivacaine - A Randomised Clinical Trial at VIMSAR, Burla

Abstract

Malaya Kumar Patel1, Dulal Kishun Soren2, Girija Shankar Prasad Patro3, Ananta Narayana Patra4, Bidyapati Padhan5, Kshitish Kumar Parija6, Saswat Satapathy7

BACKGROUND
Post-operative pain is a ubiquitous finding following any surgeries. It has
physiological and psychological effect in patients. The source and degree of
nociceptive stimulation differ among individuals and type of surgeries. In this
regard, multimodal analgesic approach has been encouraged for post-operative
pain relief, local infiltration of wound site being simplest among them. This
procedure reduces the sensitisation and consequent hyperalgesia by cutting down
afferent impulses from site of incision and injury.
METHODS
This is a single blind randomized clinical trial conducted at surgery main operation
theatre, surgery indoor wards for a duration of 2 years. 60 patients posted for
routine surgeries under general anaesthesia were taken as study subjects and
were randomly divided into 2 groups of 30 each. Before skin closure, skin wound
site was infiltrated at 1ml/cm according to the following schedule - Group B:
received Inj. Bupivacaine plain (0.2 %), Group R: received Inj. Ropivacaine plain
(0.2 %). All the patients were followed up for 24 hours and post-operative pain
score parameters (Visual Analogue Score) were taken at 1 hour, 2-hour, 6-hour,
10 hour and 24 hours. The time duration till the requirement of first dose of rescue
analgesia was noted down. Data was analysed using chi-square test, student t -
test and statistical significance was set at P < 0.05.
RESULTS
Hemodynamic stability was more with Ropivacaine as the fall in blood pressure
and heart rate was not drastic. Duration of analgesia was longer with
Ropivacaine. Analgesia was better with Ropivacaine. Both the drugs caused
analgesia of significant extent. No cardiotoxicity or any other adverse reaction
was observed with either drug in this study.
CONCLUSIONS
Ropivacaine is having longer duration of analgesia and better analgesic effect
than bupivacaine.
 

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