• 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 Wawer, and Ronald Gray.
• Rakai Health Sciences Program, Entebbe, Uganda. gkigozi@rhsp.org
• BJU Int. 2012 Apr 1; 109 (7): 1068-71.

ObjectiveTo 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 MethodsThe 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.ResultsPatient 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).ConclusionThe LBmix significantly reduced pain associated with MC and the need for additional anaesthesia during MC.© 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

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