Wound infiltration with local anaesthetics with or without adjuvant is an alternative and acceptable method for the management of postoperative pain. In this study wound infiltration with two newer drugs ropivacaine and lornoxicam (a well tolerated injectable NSAID) either alone or in combination were performed regarding analgesic efficacy and patient outcome.
Materials and Methods: 90 women of ASA I and II, undergoing elective total abdominal hysterectomy underwent this prospective, randomized, double-blinded trial. A standardized general endotracheal anaesthesia was performed on all patients. After hysterectomy and during closure, wound infiltration was performed by the surgeon using either: (Group R; 30 patients) 18 mL of ropivacaine 0.5% with 2 mL of normal saline; (Group L; 30 patients) 2 mL (8 mg) of lornoxicam (4 mg/ml) with 18 mL of normal saline; (Group RL; 30 patients) 18 mL of ropivacaine 0.5% with 2 mL (8 mg) of lornoxicam. Patients were observed for postoperative VAS scores, duration of analgesia and bowel functions over the first 24 hours.
Results: All three groups had comparable demographics and operative duration. Pain scores were significantly lower in the Group RL during the first four hours postoperatively (P < 0.01). The time to first analgesic requirement (duration of analgesia) was also prolonged in RL group (P < 0.05). However, the supplemental postoperative pethidine requirement was similar between the groups (P > 0.05). Return of bowel functions were also similar (P >0.05). No patients complained of any severe adverse effects.
Conclusion: Wound infiltration with either ropivacaine or lornoxicam or their combination is ineffective in providing prolonged postoperative analgesia after abdominal hysterectomy.
Rovivacaine; Lornoxicam; Wound infiltration; Postoperative analgesia