Effect of preincision versus postincision infiltration with bupivacaine on postoperative pain

Preoperative ropivacaine infiltration in breast surgery

“…Whether the infiltration should be performed before or after surgery has been a matter of debate. During abdominal hysterectomy, both pre-and postincision infiltration with bupivacaine 0.5% failed to alter the postoperative pain response (24). Neither did preincisional ropivacaine infiltration reduce long-term pain following laparotomy (25).…”

“…Administration of local anaesthetics in the surgical wound is a simple and attractive technique to improve postoperative pain relief. However, controversy exists regarding the efficacy of this technique (2)(3)(4)(5). Preoperative wound infiltration may reduce postoperative pain more than postoperative infiltration after hernia repair in children (6), while no such effect is observed with preincisional infiltration after cholecystectomy (7).…”

“…Pain at rest after breast surgery measured by using a 100 mm VAS scale (0Ωno pain to 100Ωsevere pain) at 0,1,2,3,4,5,6,12,18 and 24 h postoperatively. Mean∫SD.…”

Lack of pre‐emptive analgesic effect of (R)‐ketamine in laparoscopic cholecystectomy

“…Another reason for the lack of pre-emptive effect of (R)-ketamine in our study, may be pre-emptive effects in all the groups from some of the other drugs used as part of the anesthetic technique. Opioids (13), NSAIDs (14) and local anesthetic infiltration (15,16) have all been shown in some studies to have possible pre-emptive effect, whereas others studies have not found any such effect (17)(18)(19)(20). All patients received fentanyl and ketorolac during surgery and this may have partially masked the pre-emptive analgesic effect of (R)-ketamine.…”

Effect of Pre-Incision Skin Infiltration on Post-Hysterectomy Pain—A Double-Blind Randomized Controlled Trial

“…To date, five randomized controlled trials have evaluated the effect of local anaesthetic infiltration after abdominal hysterectomy [2][3][4][5][6] . Improvement in postoperative analgesia was demonstrated in two of the studies 2,3 .…”