Local Anesthetic May Speed Wound Healing

Continuous infusion of the local painkiller bupivacaine into surgical wounds appears to increase oxygenation to the site, which may in turn promote wound healing and prevent post-operative wound infections, new research shows.

Dr. Masood Ahmad, at the University of Berne, Switzerland, and colleagues evaluated the effect of local anesthetics on tissue oxygenation in 45 patients who had undergone radical prostatectomy. Patients were randomly assigned to treatment with bupivacaine, ropivacaine or saline solution.After a loading dose was injected into the wound at the end of the surgical procedure, the study drugs were infused continuously for 18 to 24 hours.For comparison purposes, tissue oxygen levels were measured at a control site in the upper arm as well as at the wound site during recovery and on the day after surgery. The results were reported at the Annual Meeting of the American Society of Anesthesiologists last month in Las Vegas.There was little difference in oxygenation between upper arm sites and wound sites for patients treated with saline or ropivacaine, Ahmad’s team reported.However, oxygenation was increased substantially at the wound site in patients treated with bupivacaine.The difference was “huge,” said Dr. Alan Dine, a researcher with the company that makes the infusion pumps used in the experiment. He told Reuters Health that previous research has shown that improved tissue oxygenation “leads to good pain management and helps the body heal well, with good post-op oxygenation to prevent infection.”The research team plans to further investigate the effect of bupivacaine on wound tissue oxygenation, Dr. Andrea Kurz, an anesthesiologist at the University of Berne, told Reuters Health.If the findings hold up, the researchers will conduct a larger study to confirm that increased tissue oxygenation leads to better wound healing and fewer post-operative infections. (Source: Reuters, Nov 2004)