Bupivacaine wound infiltration reduces postoperative pain and analgesic requirement after thyroid surgery

Sellami, M.; Feki, Sawsan; Triki, Z.; Zghal, Jamil; Zouche, Imen; Hammami, B.; Charfeddine, Ilhem; Chaari, M.; Ghorbel, Abdelmonem

doi:10.1007/s00405-018-4933-4

Cited by 21 publications

(24 citation statements)

References 19 publications

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“…The lower pain score reflects that the bupivacaine group had a higher satisfaction level and less analgesic consumption. These findings correlate well with the present studies, which demonstrated that bupivacaine infiltration reduces postoperative pain in the first 24 hours of surgery without adverse cardiological or neurological effects [19,20]. The results exhibited that although local infiltration is a useful technique that can be adapted to manage postoperative pain in several surgeries, such as abdominal surgeries (total abdominal hysterectomy, colorectal surgery, cesarean section, and inguinal hernia), laminectomy, radical prostatectomy, laparoscopic cholecystectomy, breast surgeries, and hallux valgus surgery [21,22].…”

Section: Discussionsupporting

confidence: 92%

Comparison of the Analgesic Effect of Subcutaneous Bupivacaine Infiltration and Intravenous Diclofenac vs. Intravenous Diclofenac Monotherapy After Inguinal Hernioplasty: A Retrospective Study

Alijla¹,

Amran²

2022

Cureus

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BackgroundPostoperative pain is a significant problem encountered by patients after a surgical intervention, and there is a crucial need for effective postoperative pain control. The studies have shown that multimodal analgesia and wound infiltration are effective ways to reduce this pain and have a substantial role in the reduction of postoperative medications requirement. This study aimed to evaluate the effect of subcutaneous infiltration of bupivacaine hydrochloride and intravenous (IV) diclofenac as postoperative pain relief in adults undergoing inguinal hernia repair. MethodsA single-center retrospective study included 104 patients aged 18-65 undergoing unilateral inguinal herniorrhaphy at the selected hospital. The patients were in two groups of 52 each. Group A received a 75 mg dose of IV diclofenac plus a subcutaneous injection of 10 mL of bupivacaine hydrochloride (HCl) 0.5% while Group B only received the IV diclofenac without the bupivacaine injection. The postoperative pain was assessed at one, two, three, six, and 12 hrs after the operation using the visual analog scale (VAS), which exhibited a range of pain from zero (no pain) to 10 (extreme pain). ResultsOf a total of 104 patients, 92% of patients were male. The patients' mean age was 36 ± 11 years, and the mean body mass index (BMI) was 22 ±3 kg/m 2 . American Society of Anesthesiologists physical class I was similar in both groups (90.4% versus 84.6%). Patients in Group A had significantly lower VAS pain scores at one, two, three, six, and 12 hrs after the operation and a longer emergence time than Group B (all p-values were < 0.001). Subcutaneous bupivacaine infiltration and IV diclofenac were also found to be an effective analgesic technique in open hernia repair with mesh (p-value < 0.001 for all). ConclusionSubcutaneous injection of bupivacaine combined with IV diclofenac provides superior analgesia to monotherapy intravenous diclofenac after inguinal hernia repair.

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Section: Discussionsupporting

confidence: 92%

Comparison of the Analgesic Effect of Subcutaneous Bupivacaine Infiltration and Intravenous Diclofenac vs. Intravenous Diclofenac Monotherapy After Inguinal Hernioplasty: A Retrospective Study

Alijla¹,

Amran²

2022

Cureus

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“…Authors rarely explore the WI's effectiveness in thyroid surgery, and results are seldom comparable due to heterogeneity in study design and medication selection. WI with bupivacaine (0.5%, 10 mL) reduced postoperative pain scores and analgesic consumption up to 24 h after surgery compared to no infiltration at all [196,197] or placebo [198]. Singleshot WI with ropivacaine (0.75%) at the end of thyroid surgery did not show any significant analgesic benefit compared to placebo [199].…”

Section: Thyroid Surgerymentioning

confidence: 91%

Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review

Stamenković

Bezmarević

Bojić

et al. 2021

JCM

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Local anesthetic wound infiltration (WI) provides anesthesia for minor surgical procedures and improves postoperative analgesia as part of multimodal analgesia after general or regional anesthesia. Although pre-incisional block is preferable, in practice WI is usually done at the end of surgery. WI performed as a continuous modality reduces analgesics, prolongs the duration of analgesia, and enhances the patient’s mobilization in some cases. WI benefits are documented in open abdominal surgeries (Caesarean section, colorectal surgery, abdominal hysterectomy, herniorrhaphy), laparoscopic cholecystectomy, oncological breast surgeries, laminectomy, hallux valgus surgery, and radical prostatectomy. Surgical site infiltration requires knowledge of anatomy and the pain origin for a procedure, systematic extensive infiltration of local anesthetic in various tissue planes under direct visualization before wound closure or subcutaneously along the incision. Because the incidence of local anesthetic systemic toxicity is 11% after subcutaneous WI, appropriate local anesthetic dosing is crucial. The risk of wound infection is related to the infection incidence after each particular surgery. For WI to fully meet patient and physician expectations, mastery of the technique, patient education, appropriate local anesthetic dosing and management of the surgical wound with “aseptic, non-touch” technique are needed.

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“…Other studies in patients undergoing thyroidectomy/parathyroidectomy have described postdischarge narcotic use before the first outpatient visit or the effect of a single modality on pain or narcotic administration. 12-16…”

Section: Multimodal and Opioid-sparing Analgesiamentioning

confidence: 99%

Postoperative Analgesic Requirement and Pain Perceptions after Nonaerodigestive Head and Neck Surgery

Stephenson

Farzal

Jowza

et al. 2019

Otolaryngol.--head neck surg.

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Objectives Little data exist on associations between patient factors and postoperative analgesic requirement after head and neck (H&N) surgeries. Such information is important for optimizing postoperative care considering concerns regarding opioid misuse. We analyzed factors associated with narcotic use and pain perception following H&N surgery sparing the upper aerodigestive tract. Study Design Prospective cohort. Setting Tertiary referral center. Subjects and Methods From May to October 2017, data were collected for patients undergoing nonaerodigestive H&N procedures requiring hospitalization. Patients completed a preoperative survey querying chronic pain history, narcotic usage, and postoperative pain expectation. Demographics, surgical data, postoperative narcotic use defined by morphine milligram equivalents (MME), pain scores, and Overall Benefit of Analgesia Score (OBAS) were analyzed. Results Seventy-six patients, 44 (57.9%) females and 32 (42.1%) males with a mean age of 54.0 years, met inclusion criteria. The most common procedures were parotidectomy (27.6%) and total thyroidectomy (19.7%). Average cumulative 24-hour postoperative MME and calculated MME per hospital day (MME/HD, cumulative MME for hospitalization divided by length of stay) were 40.5 ± 30.6 and 60.8 ± 60.1, respectively. Average pain score throughout the initial 24 hours after surgery was 3.7/10 ± 2.0. Female sex and prior chronic pain diagnosis were associated with higher OBAS after multivariate linear adjustments. Conclusion Postoperative narcotic requirement in nonaerodigestive H&N surgery is overall low. Female sex and prior chronic pain diagnosis may be associated with higher postoperative OBAS, a validated assessment of pain and opioid-related side effects. This study may serve as a comparison for future studies evaluating narcotic-sparing analgesia and pain perception in nonaerodigestive H&N surgery.

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Bupivacaine wound infiltration reduces postoperative pain and analgesic requirement after thyroid surgery

Abstract: Bupivacaine application is effective in decreasing postoperative pain and analgesic requirement during the hospital stay for patients with thyroidectomy.

Cited by 21 publications

References 19 publications

Comparison of the Analgesic Effect of Subcutaneous Bupivacaine Infiltration and Intravenous Diclofenac vs. Intravenous Diclofenac Monotherapy After Inguinal Hernioplasty: A Retrospective Study

Comparison of the Analgesic Effect of Subcutaneous Bupivacaine Infiltration and Intravenous Diclofenac vs. Intravenous Diclofenac Monotherapy After Inguinal Hernioplasty: A Retrospective Study

Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review

Postoperative Analgesic Requirement and Pain Perceptions after Nonaerodigestive Head and Neck Surgery

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