THE EFFECT OF INCISIONAL INFILTRATION OF BUPIVACAINE HYDROCHLORIDE UPON PULMONARY FUNCTIONS, ATELECTASIS AND NARCOTIC NEED FOLLOWING ELECTIVE CHOLECYSTECTOMY

  • 1 January 1983
    • journal article
    • research article
    • Vol. 157  (4) , 338-340
Abstract
Forty randomly selected patients admitted for elective cholecystectomy were studied. Arterial blood gas analysis, FVC [forced vital capacity] and FEV1 [forced expiratory volume] were measured preoperatively and on the 2nd postoperative day. Preoperatively and on the 3rd postoperative day, roentgenograms of the chest were obtained. The frequency of administration of narcotics was recorded through day 3. The double-blind method selected 17 patients for infiltration of 50 ml of 0.25% bupivacaine hydrochloride into the wound and 23 patients for infiltration of 50 ml of normal saline solution at the time of closure of the incision. In the saline solution group, postoperative FVC and FEV1 values were only 50% of the preoperative levels (P < 0.005), while in the bupivacaine hydrochloride group, the FEV1 value was 72% of the preoperative values (P < 0.05) and the FVC, 78% (P < 0.05). Roentgenographic evidence of atelectasis occurred postoperatively in 4 patients of the saline solution group and in only 9 patients of the bupivacaine hydrochloride group (P < 0.001). The saline solution group required 10.8 doses of narcotic through day 3 in contrast with 6.5 doses for the bupivacaine hydrochloride group (P < 0.05). The hospital stay was 6.6 days for those in the saline solution group and 5.9 days for those in the bupivacaine hydrochloride group (P value, not significant). No complications occurred. Intraoperative infiltration of bupivacaine hydrochloride into the wound improves pulmonary function, reduces the incidence of atelectases and lessens the use of narcotics following cholecystectomy.

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