Ann Surg Treat Res.  2020 Feb;98(2):96-101. 10.4174/astr.2020.98.2.96.

Effect of bupivacaine on postoperative pain and analgesics use after single-incision laparoscopic appendectomy: double-blind randomized study

Affiliations
  • 1Department of Surgery, Myongji Hospital, Goyang, Korea. hashimot@naver.com
  • 2Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea.
  • 3Department of Anesthesiology, Myongji Hospital, Goyang, Korea.

Abstract

PURPOSE
Local anesthetics can decrease postoperative pain after appendectomy. This study sought to verify the efficacy of bupivacaine on postoperative pain and analgesics use after single-incision laparoscopic appendectomy (SILA).
METHODS
Between March 2014 and October 2015, 68 patients with appendicitis agreed to participate in this study. After general anesthesia, patients were randomized to bupivacaine or control (normal saline) groups. The assigned drugs were infiltrated into subcutaneous tissue and deep into anterior rectus fascia. Postoperative analgesics use and pain scores were recorded using visual analogue scale (VAS) by investigators at 1, 8, and 24 hours and on day 7. All surgeons, investigators and patients were blinded to group allocation.
RESULTS
Thirty patients were allocated into the control group and 37 patients into bupivacaine group (one patient withdrew consent before starting anesthesia). Seven from the control group and 4 from the bupivacaine group were excluded. Thus, 23 patients in the control group and 33 in the bupivacaine group completed the study. Preoperative demographics and operative findings were similar. Postoperative pain and analgesics use were not different between the 2 groups. Subgroup analysis determined that VAS pain score at 24 hours was significantly lower in the bupivacaine group (2.1) than in the control group (3.8, P = 0.007) when surgery exceeded 40 minutes. During immediate postoperative period, bupivacaine group needed less opioids (9.1 mg) than control (10.4 mg).
CONCLUSION
Bupivacaine did not decrease pain and analgesics use. When surgery exceeded 40 minutes, bupivacaine use might be associated with less pain and less analgesics use.

Keyword

Appendicitis; Bupivacaine; Laparoscopy; Local anesthesia; Postoperative pain

MeSH Terms

Analgesics*
Analgesics, Opioid
Anesthesia, General
Anesthesia, Local
Anesthetics, Local
Appendectomy*
Appendicitis
Bupivacaine*
Demography
Fascia
Humans
Laparoscopy
Pain, Postoperative*
Postoperative Period
Research Personnel
Subcutaneous Tissue
Surgeons
Analgesics
Analgesics, Opioid
Anesthetics, Local
Bupivacaine

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