Wound infiltration with lidocaine prolongs postoperative analgesia after haemorrhoidectomy with spinal anaesthesia

Hiroshi Morisaki, Junichi Masuda, Kazuaki Fukushima, Yasuhide Iwao, Kazunori Suzuki, Makoto Matsushima

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Purpose: There are few clinical data examining whether sensitization of peripheral nerves contributes to postoperative pain when the entry of noxious impulses to the central nervous system is blocked. We hypothesized that wound infiltration with lidocaine would provide better postoperative analgesia than with normal saline following haemorrhoidectomy with spinal blockade. Methods: In a randomized, placebo-controlled, blinded study, 168 adults undergoing haemorrhoidectomy were allocated to two groups. In Group L (n = 88) local infiltration was provided with lidocaine 1% and in Group S (n = 80) with normal saline. Following spinal anaesthesia with lidocaine 3%, the surgeon infiltrated 15 ml of either infiltration solution to the surgical area. Postoperative analgesia was obtained by continuous epidural administration of 90 mg eptazocine in normal saline for 48 hr. Supplemental analgesics were given on request. Postoperative pain control was assessed at rest and during coughing with a 10 cm VAS on the 1st, 2nd, and 3rd postoperative days (POD). Results: The VAS scores at rest in Group L were lower than those in Group S throughout the postoperative period. During coughing, VAS scores in Group S were increased on the 3rd postoperative day, while those in Group L remained constant (4.42 ± 0.27 vs 3.14 ± 0.28, P < 0.05). Fewer patients in Group L than in Group S required supplemental analgesics. Conclusion: Preoperative lidocaine infiltration to the surgical area provided prolonged postoperative analgesia in patients receiving haemorrhoidectomy with spinal anaesthesia.

Original languageEnglish
Pages (from-to)914-918
Number of pages5
JournalCanadian Journal of Anaesthesia
Volume43
Issue number9
DOIs
Publication statusPublished - 1996 Sep

Fingerprint

Hemorrhoidectomy
Spinal Anesthesia
Lidocaine
Analgesia
Wounds and Injuries
Postoperative Pain
Analgesics
Peripheral Nerves
Postoperative Period
Central Nervous System
Placebos

Keywords

  • Anaesthesia: ano-rectal
  • Anaesthetic Techniques: spinal, epidural
  • Anaesthetics, Local: lidocaine
  • Analgesia: postoperative
  • Analgesics: eptazocine, loxoprofen

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Wound infiltration with lidocaine prolongs postoperative analgesia after haemorrhoidectomy with spinal anaesthesia. / Morisaki, Hiroshi; Masuda, Junichi; Fukushima, Kazuaki; Iwao, Yasuhide; Suzuki, Kazunori; Matsushima, Makoto.

In: Canadian Journal of Anaesthesia, Vol. 43, No. 9, 09.1996, p. 914-918.

Research output: Contribution to journalArticle

Morisaki, Hiroshi ; Masuda, Junichi ; Fukushima, Kazuaki ; Iwao, Yasuhide ; Suzuki, Kazunori ; Matsushima, Makoto. / Wound infiltration with lidocaine prolongs postoperative analgesia after haemorrhoidectomy with spinal anaesthesia. In: Canadian Journal of Anaesthesia. 1996 ; Vol. 43, No. 9. pp. 914-918.
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abstract = "Purpose: There are few clinical data examining whether sensitization of peripheral nerves contributes to postoperative pain when the entry of noxious impulses to the central nervous system is blocked. We hypothesized that wound infiltration with lidocaine would provide better postoperative analgesia than with normal saline following haemorrhoidectomy with spinal blockade. Methods: In a randomized, placebo-controlled, blinded study, 168 adults undergoing haemorrhoidectomy were allocated to two groups. In Group L (n = 88) local infiltration was provided with lidocaine 1{\%} and in Group S (n = 80) with normal saline. Following spinal anaesthesia with lidocaine 3{\%}, the surgeon infiltrated 15 ml of either infiltration solution to the surgical area. Postoperative analgesia was obtained by continuous epidural administration of 90 mg eptazocine in normal saline for 48 hr. Supplemental analgesics were given on request. Postoperative pain control was assessed at rest and during coughing with a 10 cm VAS on the 1st, 2nd, and 3rd postoperative days (POD). Results: The VAS scores at rest in Group L were lower than those in Group S throughout the postoperative period. During coughing, VAS scores in Group S were increased on the 3rd postoperative day, while those in Group L remained constant (4.42 ± 0.27 vs 3.14 ± 0.28, P < 0.05). Fewer patients in Group L than in Group S required supplemental analgesics. Conclusion: Preoperative lidocaine infiltration to the surgical area provided prolonged postoperative analgesia in patients receiving haemorrhoidectomy with spinal anaesthesia.",
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