Use of a mixture of lignocaine and bupivacaine vs lignocaine alone for male circumcision under local anaesthesia in Rakai, Uganda

Godfrey Kigozi, Richard Musoke, Margaret Anyokorit, James Nkale, Nehemiah Kighoma, William Ssebanenya, Joshua Mwinike, Stephen Watya, Fred Nalugoda, Joseph Kagaayi, Grace Nalwoga, Gertrude Nakigozi, Noah Kiwanuka, Frederick Makumbi, Tom Lutalo, David Serwadda, Maria J Wawer, Ronald H Gray

Research output: Contribution to journalArticle

Abstract

Objective To assess self-reported pain control during and after surgery with a mixture of lignocaine and bupivacaine compared with lignocaine alone among male circumcision (MC) service recipients in Rakai, Uganda. Patients and Methods The two formulations of local anaesthesia for MC were used alternatively at weekly intervals in 360 patients; 179 received lignocaine alone and 181 received the lignocaine and bupivacaine mixture (LBmix). The proportions of men reporting pain during or after surgery, and the need for additional anaesthesia during surgery were determined for the LBmix vs lignocaine using Poisson adjusted rate ratios (RRs). Characteristics including age, weight, surgeon (medical officer vs clinical officer), surgical method and duration of surgery were compared between the arms using two-sample t-tests and chi-square tests. Results Patient and provider characteristics were comparable between the two anaesthetic groups. A higher proportion of patients reported pain during surgery in the lignocaine group (adjusted RR 11.6, 95% confidence interval [CI] 3.5-37.9, P <0.001), required additional anaesthesia (adjusted RR 4.8, 95% CI 1.4-17.1, P= 0.015), and were more likely to report pain during the immediate postoperative period (adjusted RR 3.4, 95% CI 2.3-5.0, P <0.001). These differences were particularly marked among patients with MC times longer than the median (adjusted RR 13.4, 95% CI 3.1-57.0, P <0.001). Conclusions The LBmix significantly reduced pain associated with MC and the need for additional anaesthesia during MC.

Original languageEnglish (US)
Pages (from-to)1068-1071
Number of pages4
JournalBJU International
Volume109
Issue number7
DOIs
StatePublished - Apr 2012

Fingerprint

Male Circumcision
Uganda
Bupivacaine
Local Anesthesia
Lidocaine
Pain
Confidence Intervals
Anesthesia
Chi-Square Distribution
Postoperative Period
Anesthetics
Weights and Measures

Keywords

  • anaesthetic mixture
  • bupivacaine
  • lignocaine
  • local anaesthesia
  • male circumcision
  • pain control

ASJC Scopus subject areas

  • Urology

Cite this

Use of a mixture of lignocaine and bupivacaine vs lignocaine alone for male circumcision under local anaesthesia in Rakai, Uganda. / Kigozi, Godfrey; Musoke, Richard; Anyokorit, Margaret; Nkale, James; Kighoma, Nehemiah; Ssebanenya, William; Mwinike, Joshua; Watya, Stephen; Nalugoda, Fred; Kagaayi, Joseph; Nalwoga, Grace; Nakigozi, Gertrude; Kiwanuka, Noah; Makumbi, Frederick; Lutalo, Tom; Serwadda, David; Wawer, Maria J; Gray, Ronald H.

In: BJU International, Vol. 109, No. 7, 04.2012, p. 1068-1071.

Research output: Contribution to journalArticle

Kigozi, G, Musoke, R, Anyokorit, M, Nkale, J, Kighoma, N, Ssebanenya, W, Mwinike, J, Watya, S, Nalugoda, F, Kagaayi, J, Nalwoga, G, Nakigozi, G, Kiwanuka, N, Makumbi, F, Lutalo, T, Serwadda, D, Wawer, MJ & Gray, RH 2012, 'Use of a mixture of lignocaine and bupivacaine vs lignocaine alone for male circumcision under local anaesthesia in Rakai, Uganda', BJU International, vol. 109, no. 7, pp. 1068-1071. https://doi.org/10.1111/j.1464-410X.2011.10505.x
Kigozi, Godfrey ; Musoke, Richard ; Anyokorit, Margaret ; Nkale, James ; Kighoma, Nehemiah ; Ssebanenya, William ; Mwinike, Joshua ; Watya, Stephen ; Nalugoda, Fred ; Kagaayi, Joseph ; Nalwoga, Grace ; Nakigozi, Gertrude ; Kiwanuka, Noah ; Makumbi, Frederick ; Lutalo, Tom ; Serwadda, David ; Wawer, Maria J ; Gray, Ronald H. / Use of a mixture of lignocaine and bupivacaine vs lignocaine alone for male circumcision under local anaesthesia in Rakai, Uganda. In: BJU International. 2012 ; Vol. 109, No. 7. pp. 1068-1071.
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abstract = "Objective To assess self-reported pain control during and after surgery with a mixture of lignocaine and bupivacaine compared with lignocaine alone among male circumcision (MC) service recipients in Rakai, Uganda. Patients and Methods The two formulations of local anaesthesia for MC were used alternatively at weekly intervals in 360 patients; 179 received lignocaine alone and 181 received the lignocaine and bupivacaine mixture (LBmix). The proportions of men reporting pain during or after surgery, and the need for additional anaesthesia during surgery were determined for the LBmix vs lignocaine using Poisson adjusted rate ratios (RRs). Characteristics including age, weight, surgeon (medical officer vs clinical officer), surgical method and duration of surgery were compared between the arms using two-sample t-tests and chi-square tests. Results Patient and provider characteristics were comparable between the two anaesthetic groups. A higher proportion of patients reported pain during surgery in the lignocaine group (adjusted RR 11.6, 95{\%} confidence interval [CI] 3.5-37.9, P <0.001), required additional anaesthesia (adjusted RR 4.8, 95{\%} CI 1.4-17.1, P= 0.015), and were more likely to report pain during the immediate postoperative period (adjusted RR 3.4, 95{\%} CI 2.3-5.0, P <0.001). These differences were particularly marked among patients with MC times longer than the median (adjusted RR 13.4, 95{\%} CI 3.1-57.0, P <0.001). Conclusions The LBmix significantly reduced pain associated with MC and the need for additional anaesthesia during MC.",
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AU - Kigozi, Godfrey

AU - Musoke, Richard

AU - Anyokorit, Margaret

AU - Nkale, James

AU - Kighoma, Nehemiah

AU - Ssebanenya, William

AU - Mwinike, Joshua

AU - Watya, Stephen

AU - Nalugoda, Fred

AU - Kagaayi, Joseph

AU - Nalwoga, Grace

AU - Nakigozi, Gertrude

AU - Kiwanuka, Noah

AU - Makumbi, Frederick

AU - Lutalo, Tom

AU - Serwadda, David

AU - Wawer, Maria J

AU - Gray, Ronald H

PY - 2012/4

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N2 - Objective To assess self-reported pain control during and after surgery with a mixture of lignocaine and bupivacaine compared with lignocaine alone among male circumcision (MC) service recipients in Rakai, Uganda. Patients and Methods The two formulations of local anaesthesia for MC were used alternatively at weekly intervals in 360 patients; 179 received lignocaine alone and 181 received the lignocaine and bupivacaine mixture (LBmix). The proportions of men reporting pain during or after surgery, and the need for additional anaesthesia during surgery were determined for the LBmix vs lignocaine using Poisson adjusted rate ratios (RRs). Characteristics including age, weight, surgeon (medical officer vs clinical officer), surgical method and duration of surgery were compared between the arms using two-sample t-tests and chi-square tests. Results Patient and provider characteristics were comparable between the two anaesthetic groups. A higher proportion of patients reported pain during surgery in the lignocaine group (adjusted RR 11.6, 95% confidence interval [CI] 3.5-37.9, P <0.001), required additional anaesthesia (adjusted RR 4.8, 95% CI 1.4-17.1, P= 0.015), and were more likely to report pain during the immediate postoperative period (adjusted RR 3.4, 95% CI 2.3-5.0, P <0.001). These differences were particularly marked among patients with MC times longer than the median (adjusted RR 13.4, 95% CI 3.1-57.0, P <0.001). Conclusions The LBmix significantly reduced pain associated with MC and the need for additional anaesthesia during MC.

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KW - male circumcision

KW - pain control

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