Evaluation of a bupivacaine injection in the management of post-saphenectomy pain in patients undergoing coronary revascularisation surgery

Abstract

Introduction and objective: Recent studies emphasise the presence of severe pain in the lower extremities post-saphenectomy. Although local infiltration in the treatment of surgical pain is widespread in many surgeries, it has not been used in coronary artery bypass grafting so far. The aim of this study was to evaluate the local infiltration of bupivacaine in the management of post-saphenectomy pain.Method: A prospective study was conducted with two cohorts of patients that were randomly included in two groups: control group (CG) where the surgical wound closure after the saphenectomy was treated in a conventional manner, and the intervention group (GI) where it was infiltrated after the closure with 50 mg of bupivacaine throughout the post-saphenectomy surgical wound. The patient profile, iterative variables, and intensity of pain were analysed using a Visual Analogue Scale (VAS). Informed consent was obtained and the data was analysed using the SPSS statistical package version 22.0.Results: On the lower limb selected post-saphenectomy, the CG experienced the greatest severe pain (VAS >= 4) at two (P=.043), four (P=.001), and twelve (P=.017) hours post-operative. However, it was the GI that suffered the most complications of the surgical wound (haematomas, P=.016, and (infections, P=.019).Conclusions: Patients who received an injection of 50 mg of bupivacaine into the post-saphenectomy surgical wound presented with a lower intensity pain in the lower limb selected both at rest and with movement during the post-operative period compared to those who did not receive one. (c) 2017 Published by Elsevier Espana, S.L.U. on behalf of Sociedad Espanola de Cirugia Toracica-Cardiovascular. This is an open access article under the CC BY-NC-ND license.