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The effects of incisional bupivacaine on postoperative narcotic requirements, oxygen saturation and length of stay in the post‐anesthesia care unit
Author(s) -
Partridge B. L.,
Stabile B. E.
Publication year - 1990
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1990.tb03129.x
Subject(s) - pacu , medicine , anesthesia , narcotic , bupivacaine , local anesthetic , saline , post anesthesia care unit , placebo , morphine , narcotic analgesics , surgery , alternative medicine , pathology
We compared postoperative pain and narcotic requirements, oxygen saturation (Sao 2 ) and length of stay in the post‐anesthesia care unit (PACU) in patients who received 30 ml of either 0.25% bupivacaine (B) or saline placebo (S) infiltrated into the operative incision. Twenty ASA I–III patients undergoing abdominal surgery were studied in a double‐blinded randomized prospective trial. Study and control groups were not different in patient age, procedure, intra‐operative narcotics administered or preoperative Sao 2 . In the PACU, patients receiving B had significantly lower analog pain scores (6.0 vs 8.3, P =0.02). They had lower respiratory rates (15.6 b/min vs 19.1, P =0.02), required significantly less narcotic (4.5 mg morphine sulphate vs 11.0, P =0.03) and were discharged from the PACU almost an hour sooner than patients receiving S ( P = 0.02). Patients receiving B had significantly higher minimum Sao 2 than those receiving S (93.3 % vs 89.9, P =0.04). Discharge pain scores, Sao 2 and respiratory rates were not significantly different between B and S groups. Finally, mean requirements for narcotics for the first 24 h were reduced by approximately 30% (from 406.9 mg meperidine to 255.5 mg, P =0.006). This study demonstrates that infiltration of a long‐acting local anesthetic lowers initial pain scores and requirement for narcotics in the PACU. The effect can be seen for at least the first 24 h. A lower requirement for postoperative narcotics is accompanished by faster wake‐up, more alert patients, and, most importantly, higher Sao 2 and shorter PACU stay. This may have a significant effect on pulmonary morbidity following abdominal operations.