Intraoperative wound infiltration with local anesthetic in open abdominal hysterectomy significantly reduces postoperative opioid consumption (wound infiltration)

Abstract

Introduction: Wound infiltration with local anesthetic could be a possible way to reduce postoperative pain. The purpose of this study was to evaluate whether local wound infiltration can reduce postoperative pain and opioid requirements. Methods: Randomised clinical research was conducted at the National cancer research center of Serbia and included 40 women who were scheduled for abdominal hysterectomy and who were randomly assigned to two groups: treatment group received wound infiltration of 20 ml 0.25 % levobupivacaine before the closure of the abdomen, while in the control group the abdomen was sutured without wound infiltration. Patients in both groups received paracetamol 30 minutes before the end of operation. After the end of surgery pain was assessed using numerical rating scale for the first 24 hours and during the episodes of coughing. If the patients assessed their pain level as 4 or less they received non-opioid analgesics. If they assessed the level of pain as 5 or more they received tramadol in appropriate dosage. Results: The average pain scores were significantly lower in the surgical site infiltration group (p < 0.05) for the whole 24-hour period and also during the episodes of coughing (p < 0.05). Opioid requirements were significantly lower in the group which received wound infiltration (p < 0.05) as well as the total average daily dose of opioid analgesic. Conclusion: This study showed that surgical site infiltration with local anesthetic improved analgesia after hysterectomy and reduced opioid requirements during the first 24 hours after operation.

Keywords

• analgesia
• wound infiltration
• local anesthetic
• hysterectomy