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COMPARATIVE ANALYSIS OF MEAN POST-OPERATIVE PAIN LEVEL AMONG PATIENTS ADMINISTERED BUPIVACAINE INFILTRATION DURING CAESAREAN SECTION VERSUS CONTROLS

Fakharunissa Waheed, Roshan Ara Kazi and Qamarunissa Muhabat

Background: Treatment of postoperative pain continues to be an ongoing concern. The injection of local anesthesia into the wound has been shown to reduce postoperative incisional pain in several studies. Bupivacaine is one such local anesthetic and its use merits to be explored. Objective: To compare the effect of bupivacaine versus placebo control on mean post-operative pain level after caesarean section. Methodology: This prospective cohort was conducted upon a sample of 100 women with term pregnancies scheduled to undergo elective caesarean section deliveries from January 2018 to June 2019 at a tertiary care hospital. Patients were randomized to receive an infusion of either 0.5% bupivacaine (n = 50) or normal saline solution (n = 50) into the wound for 48 hours. Postoperative pain (determined with a visual analog scale) and postoperative rescue analgesic (morphine) use were assessed at 12, 24, and 48 hours. The data obtained was recorded onto a structured questionnaire and analyzed using SPSS v.21 to apply student t-test. P value of less than 0.05 was taken to be significant. Results: The mean age of the women mothers stood at 29 (SD ± 8). The two treatment groups were treated by the same physicians and all had elective lower segment caesarean sections. There was a decrease in opioid consumption and pain on visual analog scale in the Group A that received bupivacaine, as compared with the placebo group. Conclusion: After careful consideration, it can be concluded that local administration of pre-emptive bupivacaine infiltration before closure of the skin decreased postoperative pain and need for rescue analgesia. Keywords: Caesarean Section, Post-Operative Pain, Local Analgesic, Local Anesthetic, & Bupivacaine.

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