evaluation of the effects of intraincisional bupivacaine in post operative pain after abdominal hysterectomy

Due to the prevalence of total abdominal hysterectomy in the gynecology and patient's need to opioids for controlling post operative pain their side effects are inevitable. Hence we designed this study to see whether or not intraincisional bupivacaine could provide ample analgesia and thus could spare opioids side effects. Sixty ASA physical status I and II patients aged 45 to 65 years old undergoing total abdominal hysterectomy were enrolled into this clinical trial and randomly assigned into two groups of case (Bupivacaine) and control (Morphine). A standard general anesthetic was administered to them all. On completion of the operation, 0.1 mg/kg morphine sulfate was injected IV in control group, and 20cc bupivacaine 0.125% was injected intraincisional. During the 1, 4, 24, 48 hours after surgery, rescue IV morphine sulfate was administered to achieve a visual analog scale score of <3. Total rescue morphine consumption, pain scores, heart rate, systolic and diastolic blood pressure, and side effects of morphine sulfate during the 1, 4, 24, 48 hours after surgery were compared in both groups. The total morphine sulfate consumption during the 1, 4, 24, 48 hours after surgery, in case group was significantly higher than control group (p<0.001). This study demonstrated that, intraincisional adminesteration of bupivacaine has no significant analgesic effect after total abdominal hysterectomy.