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Ben-Saghroune H, Abdessadek M, Achour S, Kfal Y, El Bouazzaoui A, Kanjaa N, Sbai H. Assessment of the Safety and Efficiency of a Preperitoneal Continuous Infusion Using Bupivacaine after Abdominal Laparotomy in Digestive Carcinology. Anesthesiol Res Pract 2023; 2023:8842393. [PMID: 37854305 PMCID: PMC10581849 DOI: 10.1155/2023/8842393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/19/2023] [Accepted: 08/18/2023] [Indexed: 10/20/2023] Open
Abstract
The purpose of this paper is to evaluate the safety and efficacy of continuous preperitoneal wound infiltration using bupivacaine after abdominal laparotomy in relation to plasma bupivacaine concentration and visual analog scale. Our study was performed on 60 adult patients with digestive cancer, operated at laparotomy, and randomized into two groups: bupivacaine and saline groups. The wound infiltration was through a multiperforated catheter along the scar. For the bupivacaine group, 0.25% bupivacaine was used; however, for the saline group, only saline (0.9%) was infiltrated. The pain was assessed by using the visual analog scale (VAS) in both groups. Plasma bupivacaine concentration was measured by high-performance liquid chromatography. The bupivacaine group had significantly lower postoperative morphine consumption and lower postoperative pain than the saline group (P < 0.0001). The majority of patients in the bupivacaine group had significant relief with the VAS scores of less than 3/10 cm at rest and 6/10 cm on mobilization. However, for the saline group, the VAS scores were higher than 6/10 cm either at rest or with mobilization. There was no clinical sign of toxicity and no technical complications for the bupivacaine group. Only eleven patients required morphine in this group, but the majority of patients received morphine at different doses in the saline group. Plasma bupivacaine was at very low concentrations. Overall, the current study has confirmed that continuous preperitoneal wound infiltration as postoperative analgesia is a simple, effective, and safe technique. It allows decreasing of morphine consumption and subsequently canceling their side effects.
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Affiliation(s)
- Hayat Ben-Saghroune
- Laboratory of Anesthesia-Intensive Care and Emergency Medicine, Medical Center for Biomedical and Translational Research, Faculty of Medicine and Pharmacy, University Sidi Mohamed Ben Abdellah, Fez, Morocco
| | | | - Sanae Achour
- Faculty of Medicine and Pharmacy, Biomedical and Translational Research Laboratory University Sidi Mohammed Ben Abdellah, Pharmaco-Toxicology Department, Hassan II University Hospital, Fez, Morocco
| | - Youssef Kfal
- Central Medical Analysis Laboratory, Hassan II University Hospital, Fez, Morocco
| | - Abderrahim El Bouazzaoui
- Laboratory of Anesthesia-Intensive Care and Emergency Medicine, Medical Center for Biomedical and Translational Research, Faculty of Medicine and Pharmacy, University Sidi Mohamed Ben Abdellah, Fez, Morocco
- Anesthesiology and Intensive Care Department A4, University Hospital Hassan II, Fez, Morocco
| | - Nabil Kanjaa
- Laboratory of Anesthesia-Intensive Care and Emergency Medicine, Medical Center for Biomedical and Translational Research, Faculty of Medicine and Pharmacy, University Sidi Mohamed Ben Abdellah, Fez, Morocco
- Anesthesiology and Intensive Care Department A4, University Hospital Hassan II, Fez, Morocco
| | - Hicham Sbai
- Anaesthesia and Critical Care Department, University Hospital of Tangier, Simulation Center Faculty of Medicine, University Abdelmalek Essadi, Tangier, Morocco
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Buys MJ, Johnson KB. Blocking Blindly: How to Navigate Risks of Local Anesthetic Toxicity When Liposomal Bupivacaine Has Been Used and the Patient Is Still in Pain. Anesth Analg 2020; 131:1840-1842. [PMID: 33186169 DOI: 10.1213/ane.0000000000005225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Michael J Buys
- From the Department of Anesthesiology, University of Utah, Salt Lake City, Utah
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Trabelsi B, Charfi R, Bennasr L, Marzouk SB, Eljebari H, Jebabli N, Sassi MB, Trabelsi S, Maghrebi H. Pharmacokinetics of bupivacaine after bilateral ultrasound-guided transversus abdominis plane block following cesarean delivery under spinal anesthesia. Int J Obstet Anesth 2017; 32:17-20. [DOI: 10.1016/j.ijoa.2017.04.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 03/11/2017] [Accepted: 04/14/2017] [Indexed: 10/19/2022]
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