Minimizing the Hurdle of Pain During Administration of Local Anesthesia Using Bupivacaine in Large Operative Field

Abstract

Objective: To study use of our technique and anesthetic solution in minimizing the discomfort and pain of administration of anesthetic solution without complications.
Material and Methods: This study was conducted in Prime Care Hospital from June 2022- June 2023. In this case series, we present 100 cases who underwent minor plastic surgery and general surgical procedures using our anesthetic ZA solution containing 0.5% bupivacaine (20 cc) , 1 % xylocaine (20cc) , NAHCO3 (3 cc) and epinephrine (1 cc) diluted in 250 cc Normal Saline. We injected solution in the sub-cutaneous plane with four quadrant fan shape technique via spinal needle (26G). We noted the information acquire from the patients on questionnaire form about the pain score during administration of solution along with validation from the patient for continuation of this technique on other patients along with length of analgesia.
Results: Among 100 patients, 65 were males and 35 were females. Our minimum calculated pain score
during administration was 1 maximum was 5, mean was 3, per operatively was 0 , post operatively was
0,remained 0 upto 8 hours after operation. Our calculated duration of action was 9 hours and maximum
duration was 14 hours after which patient was given oral pain killers. It is further noted that the pain tolerance
was more in age group 25-35 years and less among age group 15-25 years patients. Acceptability of
procedure was 87%. No complications were noted throughout the procedure.
Conclusion: Our anesthetic solution is cost effective, patient friendly , provides long duration of anesthesia with minimizing need of multiple pricks and re-adminstration. Hence, reducing pain experience along with validation from the patient . it requires minimum experience , equipment with high success rate.
Keywords: pain during multiple pricks, minor surgeries, Xylocaine, Bupivacaine, NAHCO3, Adrenalin