Effect of Bupivacaine Local Infiltration Compared with Parecoxib Intravenous Administered in Post Surgical Pain Management Following Total Abdominal Hysterectomy

Abstract

Objective: To compare effect of bupivacaine local infiltration with parecoxib intravenous administered for post surgical pain relief in woman undergoing abdominal hysterectomy. Materials and Methods: From August 2014 to January 2015, 42 patients scheduled for abdominal hysterectomy under general anesthesia were randomly allocated to 2 groups. Group P (n=21) were received 40 mg intravenous parecoxib and group B (n=21) were received 0.5% bupivacaine 20 mL intraoperative injection to incisional surgical site before the subcutaneous fat and skin were closed. All patients were received morphine patient-controlled analgesia (PCA) at ward. Main outcome measures: Pain scores, morphine consumption, sedation score and nausea or vomiting were assessed at 2, 6, 10, 14 and 26 hours after surgery. Antiemetic requirement, pruritus and satisfaction scores were evaluated at 26 hours after surgery. Results: No significant differences between 2 groups in age, BMI, surgical time and intraoperative dose of fentanyl were found. Pain scores at rest were significantly lower (p=0.045) in the P group at 2, 14 hours after surgery. There were no significant differences in pain scores during movement, morphine consumption, sedation score, nausea or vomiting, antiemetic requirement, pruritus and satisfaction scores between 2 groups. Conclusion: The use of parecoxib with PCA morphine in post operative analgesia reduced pain significantly when compared with bupivacaine at 2 and 14 hours after surgery.