Abdominal wound perfusion for the relief of postoperative pain

In a double-blind trial, 50 patients with subcostal incisions performed for cholecystectomy or splenectomy, received 10 ml of either 0.5% bupivacaine plain or physiological saline twice daily by wound perfusion through an indwelling drainage tube for 3 days after operation. Analgesia, assessed by visual analogue score (VAS) and forced vital capacity (FVC), was significantly improved after perfusion with bupivacaine. Perfusion with physiological saline produced an analgesic effect comparable to that of bupivacaine as indicated by improvement in VAS. There was, however, no improvement in FVC, and opioid requirements were greater, in the patients whose wounds had been perfused with saline.