THE EFFECT OF INCISIONAL INFILTRATION OF BUPIVACAINE UPON PAIN AND RESPIRATORY-FUNCTION FOLLOWING OPEN CHOLECYSTECTOMY

A controlled, prospective, double-blind trial of wound infiltration wi th bupivacaine in elective open cholecystectomy was performed to deter mine if this was an effective method of pain relief and reduced respir atory complications. Additionally, dextran was added to the bupivacain e in an attempt to prolong the effect. The solutions used were, bupiva caine alone 0.25% (n=14), bupivacaine 0.25% with dextran 70 (n=16) and saline (n=16) as a control. To determine the effect of each solution, the subjects were assessed for pain perception and respiratory functi on before and after surgery. Pain was assessed using a visual analogue scale and narcotic usage, and respiratory function was assessed by sp irometry, chest X-rays and arterial blood gases. The study did not dem onstrate any objective improvement in either pain relief or respirator y function. This may reflect inadequate infiltration by the surgeons i n the study or that infiltration should have been performed prior to i ncision.