The most important concern after the surgical intervention is pain which needs to be addressed for better compliance and early mobilization to avoid other complications. The need for a better analgesic and time of administration is the key to success.
Objective: To compare the mean post-operative pain score with pre-incisional versus post-operative injection of bupivacaine in patients undergoing elective surgery.
Study design: This Randomized controlled trial was conducted in the General surgery department, National Hospital & Medical Centre, Lahore from 24-02-20 to 24-11-20. Data was collected through Non-probability consecutive sampling. The cases of both genders with an age range of 18-60 years undergoing elective surgeries were selected. They were divided into two groups. The cases in group A were given pre-incision bupivacaine and group B with post-operative bupivacaine and were assessed 1 hour after surgery regarding pain on VAS.
Results: In the present study there were a total of 64 cases with 32 in each group. The mean age in group A was 47.56±7.51 years while in group B was 49.13±8.03 years. There were 19 (59.37%) males in group A vs 18 (56.25%) in group B. The mean post-operative pain in group A was 3.07±0.67 vs 3.59±0.91 in group B on VAS with p= 0.03. Mean post-operative pain in males was 3.12±0.65 vs 3.47±0.86 and in females, it was 3.21±0.66 vs 3.53±0.90 in groups A and B with p values of 0.21 and 0.23 respectively. Mean Post-operative pain was 3.11±0.66 vs 3.44±0.83 in the age group 18-39 years and 3.08±0.68 vs 3.47±0.88 in age group 40 to 60 years in group A and B with p values of 0.25 and 0.20 respectively. There was a significant difference in terms of postoperative pain in cases undergoing open cholecystectomy where pain was 3.21±0.78 vs 3.86±1.02 in group A and B respectively with p= 0.01. Whereas no difference was seen in the rest of the variables.
Conclusion: Mean post-operative pain is significantly better in cases treated with pre-incisional bupivacaine as compared to post-operative bupivacaine and this difference was also seen as significantly high in cases undergoing open cholecystectomy.
Keywords: Bupivacaine; Post incisional; Pre-incisional; VAS.