Evaluación de la infiltración con bupivacaína en el manejo del dolor postsafenectomía en pacientes sometidos a cirugía de revascularización coronaria

Abstract

Introduction and objectiveRecent studies emphasise the presence of severe pain in the lower extremities post-saphenectomy. Although local infiltration in the treatment of surgical pain is widespread in many surgeries, it has not been used in coronary artery bypass grafting so far. The aim of this study was to evaluate the local infiltration of bupivacaine in the management of post-saphenectomy pain. MethodA prospective study was conducted with two cohorts of patients that were randomly included in two groups: control group (CG) where the surgical wound closure after the saphenectomy was treated in a conventional manner, and the intervention group (GI) where it was infiltrated after the closure with 50mg of bupivacaine throughout the post-saphenectomy surgical wound. The patient profile, iterative variables, and intensity of pain were analysed using a Visual Analogue Scale (VAS). Informed consent was obtained and the data was analysed using the SPSS statistical package version 22.0. ResultsOn the lower limb selected post-saphenectomy, the CG experienced the greatest severe pain (VAS ≥ 4) at two (P=.043), four (P=.001), and twelve (P=.017) hours post-operative. However, it was the GI that suffered the most complications of the surgical wound (haematomas, P=.016, and (infections, P=.019). ConclusionsPatients who received an injection of 50mg of bupivacaine into the post-saphenectomy surgical wound presented with a lower intensity pain in the lower limb selected both at rest and with movement during the post-operative period compared to those who did not receive one.