title: The late effect of intraoperative wound infiltration with local anaesthetic in surgical patients; is there any? A randomized control trial.
abstract: BACKGROUND
  Intraoperative wound infiltration with local anaesthetic is commonly used. Apart from the obvious immediate action it has been supported that a possible down regulation of pain receptors may lead to longer effects. Our aim was to compare the use of local anaesthetic versus placebo in order to assess if indeed there is a late beneficial effect.
  
  
  METHODS
  We conducted an RCT involving 400 consecutive general surgery patients randomized in 2 groups: Group A = placebo, Group B = wound infiltration with 15 ml of ropivacaine 10%. We recorded the preoperative and postoperative pain for the 1st week as well as the type and quantity of the analgesia used during the study period.
  
  
  RESULTS
  No significant difference was found between the groups in all known confounding factors recorded. No significant difference was found in the intensity of postoperative pain. More people of group A required NSAIDs during the first 3 PO days while more people of Group B required stronger painkillers. For those patients who underwent a non urgent operation and especially laparoscopic surgery higher pain score was recorded in the group B from the 3rd PO day onwards.
  
  
  CONCLUSIONS
  Intraoperative local infiltration of the wound with local anaesthetic offers no further benefit for the general surgery apart from that of the immediate PO period. There is no late effect for pain control. Considering that during the immediate postoperative period stronger systematic painkillers are given the intraoperative, infiltration of the wound with the local anaesthetic under study offers no obvious benefit.
authors.affiliation: 2nd Surgical Department and Unit of Surgical Oncology, Korgialenio-Benakio, Red Cross Athens General Hospital, Greece1 Athanasaki st, Athens 11526, Greece. Electronic address: drlanitis@yahoo.com.
authors.forename: Sophocles
authors.initials: S
authors.lastname: Lanitis
authors.affiliation: 2nd Surgical Department and Unit of Surgical Oncology, Korgialenio-Benakio, Red Cross Athens General Hospital, Greece1 Athanasaki st, Athens 11526, Greece.
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Karkoulias
authors.affiliation: 2nd Surgical Department and Unit of Surgical Oncology, Korgialenio-Benakio, Red Cross Athens General Hospital, Greece1 Athanasaki st, Athens 11526, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Sgourakis
authors.affiliation: 2nd Surgical Department and Unit of Surgical Oncology, Korgialenio-Benakio, Red Cross Athens General Hospital, Greece1 Athanasaki st, Athens 11526, Greece.
authors.forename: Pantelis
authors.initials: P
authors.lastname: Brotzakis
authors.affiliation: 2nd Surgical Department and Unit of Surgical Oncology, Korgialenio-Benakio, Red Cross Athens General Hospital, Greece1 Athanasaki st, Athens 11526, Greece.
authors.forename: Vasilios
authors.initials: V
authors.lastname: Armoutides
authors.affiliation: 2nd Surgical Department and Unit of Surgical Oncology, Korgialenio-Benakio, Red Cross Athens General Hospital, Greece1 Athanasaki st, Athens 11526, Greece.
authors.forename: Constantine
authors.initials: C
authors.lastname: Karaliotas
mesh_terms: D000328:Adult; D000577:Amides; D000779:Anesthetics, Local / Q000493:pharmacokinetics*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D000077212:Ropivacaine; D013514:Surgical Procedures, Operative; D055815:Young Adult
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000077212:Ropivacaine
keywords: Determinants of pain; Local anaesthetic; Pain; Surgery; Wound infiltration