Pethidine Infiltration in Intra Fascial Layer After Abdominal Hysterectomy

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Pethidine Infiltration in Intra Fascial Layer After Abdominal Hysterectomy

Journal Title: Interventions in Gynaecology and Women’s Healthcare - Year 2018, Vol 3, Issue 1

Abstract

Introduction: multimodal analgesia regimen has a cornerstone component involving local wound infiltration with analgesic agents to manage and enhance post-operative pain to increase patient satisfaction. Aim: assessment and evaluation of effectiveness of local pethidine infiltration as a local analgesic in total abdominal hysterectomy. Methodology: A cohort of 151 cases that have undergone abdominal hysterectomy have been categorized randomly into two research groups research group I (n=74 cases), involved women that were administered both wound infiltration and IM pethidine; and research group II (n=77 cases), involving women that were administered IM pethidine. Results: The median 10-cm VAS for postoperative pain was significantly lower in women who received both WI and IM pethidine when compared to women who received only IM pethidine, 1 hour, 6 hours, 12 hours and 24 hours postoperatively. The mean total morphine consumption was lower in women who received both WI and IM pethidine when compared to women who received only IM pethidine. Conclusion: Pethidine when administered in a simultaneous manner intrafascially and intramuscularly in cases undergoing total abdominal hysterectomy is more effective in reducing post-operative pain levels. Post-operative pain management in cases undergoing total abdominal hysterectomy is considered a major challenge for both gynecologists and anesthesiologists aiming for enhancing patient satisfaction and level of health care service requiring multidisciplinary management and planning regarding the pathway of pain management of pain [1,2]. Despite the fact that epidural form of analgesia is an efficient mode of managing post-operative pain in abdominal surgeries however less invasive forms are considered more practical and applicable for many health care systems [3,4]. Local analgesia infiltration is considered a simple and efficient mode of pain management that has reduced costs in comparison to epidural analgesia. Advancing the pain management protocols could enhance patient post-operative recovery and improve clinical outcomes [5,6]. A widely implemented synthetic opioid known as pethidine causes its analgesic action by Functioning as an agonist on opioid receptors, furthermore it has been revealed and displayed to exert a local anesthetic impact chiefly via Linked to its interfaces with sodium‑ion Channels that are voltage‑dependent. peripheral nerve conduction blockage action has been revealed and displayed widely in various in vivo and in vitro experimental animal research studies that makes its applicability in clinical practice in humans a promising protocol of management [7,8].

Authors and Affiliations

Raafat TA, Mostafa M Serry

Keywords

EP ID EP581474
DOI 10.32474/IGWHC.2019.03.000153
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