Does Bupivacaine Infiltration Reduce Postoperative Pain in Patients with Caesarean Section? A Randomized Control Trial
Abstract
Objective: To assess the effects of bupivacaine wound infiltration with placebo during a caesarean section in terms of mean pain scores, analgesic need, and hospital stay duration.
Methodology: This was a randomized controlled trial, took place at the Pak Emirates Military Hospital's Department of Gynecology and Obstetrics from January 10th, to April 10th, 2021. A computer-generated lottery approach was used to divide the patients into two groups. Patients in group A received 20 ml of sterile water infiltrated into the subcutaneous tissue around the incision site, whereas patients in group B received 0.5 percent bupivacaine injection.
Results: A total of 298 patients were enrolled, with 149 patients in each group. In terms of patient age, parity, gestational duration, and indication of caesarean section, both groups had a comparable profile. At one, two, and six hours after surgery, the bupivacaine group had considerably lower pain scores, but the difference was not statistically significant at 12 hours. In comparison to patients in the placebo group, patients in the bupivacaine group required lower doses of supplemental analgesia in the form of opioid (p 0.001) and had a shorter hospital stay (p = 0.008).
Conclusion: When used as an adjunct to non-steroidal anti-inflammatory drugs (NSAIDs), local infiltration with 20 ml of 0.5 percent bupivacaine during caesarean section not only reduces postoperative pain intensity and opioid requirement, but also has a significant impact on reducing the length of hospital stay.
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