LOW DOSE INTRAVENOUS INFUSION OF LIGNOCAINE IN POST OPERATIVE PAIN

In spite of spectacular advances in pain relief during surgery, relief of pain in post operative period still remains a problem. The most important is that the deficiencies of current routine methods of pain relief are being increasingly exposed. The present study has been taken up with the intention of evaluating the postoperative analgesic effect of continuous lignocaine infusion in low doses as used for cardiac arrhythmias. Lignocaine is extensively studied regarding its pharmacology and pharmacokinetics in comparison with narcotic analgesics viz., free from respiratory depression and addiction liability. The primary action of the local anesthetic is on the cell membrane of the axon on which it produces electrical stabilization. The large transient increase in permeability to sodium ions necessary for propagation of the impulse is prevented thus the resting potential is maintained and depolarization in response to stimulation is inhibited. Patients were randomly grouped in to two groups of 50 in each. Group A given Lignocaine intravenously and Group B given saline intravenously post operatively for a period of 24 hrs. Patients were monitored by measurement of pulse rate, systolic blood pressure, continuous ECG monitoring. Post operative instructions included a note to give narcotic or sedative, if in severe pain after informing the author. Pain during 24hrs after surgery was assessed by “linear analogue” scale ranging from 0 to 100 as per Bond and Pilowsky. The study was prospective controlled and randomized. Data were expressed as mean±S.E.M. Single tailed student’t’ test was used to express the difference of the means of two samples. The results showed that continuous intravenous lignocaine decreased the postoperative pain persistently and reduced the narcotic analgesic dose significantly and did not cause any significant adverse effects. “Divine is the task to relieve pain”-Hippocrates “For all the happiness mankind can gain, is not in pleasure, but in rest from pain”-John Dryden (1631-1701) Key Words: Lignocaine, Pethidine, Linear analogue scale, Infusion, Narcotic