Efeitos pós-operatórios da infiltração de bupivacaina 0,25% com epinefrina em ferida de colecistectomia aberta

Abstract

The infiltration of local anesthetics in optimizing pain control has been used in some centers and effectiveness discussed in many types of surgery. The scope of the study was to evaluate the analgesic efficacy and some variables associated with postoperative welfare as nausea and vomiting and respiratory distress in patients undergoing 0.25% bupivacaine with epinephrine infiltration in open laparoscopic surgical wound infiltration compared to group with saline. It is a double-blind clinical trial involving 40 patients referred for open cholecystectomy. The selection of participants and the infiltrated solution were randomized. The scores obtained from the Visual Numerical Scale of Pain were submitted to the Fisher method (α = 0.05) that measured the pain Hour 1, 2 and 4 after surgery. The morphine analgesic consumption and recovery times (Mann-Whitney test; α = 0.05) and frequency of nausea and vomiting and respiratory distress were observed. Pain intensity in the three analyzed intervals (control: 4.583 ± 0.554, 4.444 ± 0.506, 3.388 ± 0.405 vs Bupivacaine: 3.409 ± 0.371, 2.545 ± 0.313, 2.000 ± 0.329), showing statistical difference. The frequency of rescue analgesia requests in infiltration with bupivacaine group was lower than the control group (18.18% vs 50%), but the consumption of opioid was not different when compared (p> 0.05). The incidence of nausea and vomiting was lower in the group infiltrated with bupivacaine (28.57%, 19.04%, 4.76% vs 40%, 26.60%, 13.30%), but there was no decrease in the incidence of respiratory distress. Conclusion: The infiltration of 0.25% bupivacaine with epinephrine proved to be a good alternative analgesic and was effective in reducing the incidence of nausea and vomiting after surgery.