A randomized, controlled trial to determine the effectiveness of fascial infiltration of XXXX in preventing respiratory complications after elective abdominal surgery.

@entity1 @entity1341 @entity891 @entity260
A randomized, controlled trial was performed to determine whether infiltration of fascia with @entity1341 , a long-acting local anesthetic, at the time of closure after elective laparotomy, is effective in preventing @entity260 . At the Toronto General Hospital 415 @entity1 undergoing elective laparotomy were randomly allocated to receive @entity1341 0.25% (2 ml/cm incision), infiltrated into the fascia evenly along both sides of the incision before wound closure (202 @entity1 ), or to have closure without infiltration (213 @entity1 ). Chest x-ray (CXR) films of all @entity1 were obtained preoperatively and on the second postoperative day. Pulmonary function studies were performed preoperatively and for the first two consecutive days postoperatively. CXR films were scored by a blinded observer. Postoperatively, 64% of the treatment group and 56% of the control group had evidence of @entity891 on CXR films (p = NS, chi 2 test). Both groups had similar decrements in vital capacity and expiratory reserve volume on the first and second postoperative days. There was no significant difference in the amount of analgesic taken in the first 24 hours, although the time to first analgesic was significantly longer in the treatment group (2.2 vs 1.3 hours, p less than 0.055). We conclude that infiltration of the fascia with 0.25% @entity1341 at a dose of 2 ml/cm of incision is not effective in preventing @entity891 . It does not reduce use of an analgesic although it may delay its initial requirement.
