Table of Contents
Advances in Anesthesiology
Volume 2016, Article ID 2861217, 4 pages
http://dx.doi.org/10.1155/2016/2861217
Clinical Study

The Use of Lidocaine and Bupivacaine Mix in Adult Safe Male Circumcision: Less Is More

1International Hospital Kampala, Surgery Department, Mulago Hospital, Kampala, Uganda
2Department of Surgery, College of Health Sciences, Makerere University, Kampala, Uganda
3International Hospital Kampala, Kampala, Uganda
4International Medical Group, Kampala, Uganda
5Infectious Diseases Institute, Makerere University, Kampala, Uganda

Received 11 January 2016; Accepted 21 February 2016

Academic Editor: Takashi Kawano

Copyright © 2016 M. Galukande et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Lignocaine is (with or without bupivacaine) the only drug recommended for local anesthesia for safe adult male circumcision (SMC). This study evaluated the effectiveness of postoperative pain control when using two different concentrations. Methods. An observational analytical study conducted at an urban high volume site. Pain was assessed using the Visual Analogue Scale. Mixtures of lignocaine 2%, bupivacaine 0.5% (LiB), and water in ratios of 4 : 4 : 2 and 3 : 3 : 4 were compared. Results. Data from 217 clients were analyzed: 100 in the 4 : 4 : 2 group and 117 in the 3 : 3 : 4 group. Clients in the 4 : 4 : 2 group had more pain, at 60 minutes, compared to the 3 : 3 : 4 group (). The 3 : 3 : 4 mix used 70% less lignocaine and 90% less bupivacaine (60 mg and 15 mg); the allowable maximum dosages are 200 mg and 150 mg, respectively. Conclusion. The 3 : 3 : 4 mix was superior to the 4 : 4 : 2 mix. This has implications for supply chain management and potential reduction of LA toxicity. We therefore recommend the 3 : 3 : 4 mix for routine adult SMC.