Pain relief after inguinal hernia repair: A randomized double-blind study

Abstract

A randomized double-blind study was undertaken using 0.5 per cent bupivacaine ilioinguinal field block and oral papaveretum-aspirin tablets to assess pain relief after hernia surgery. A consecutive series of 200 men undergoing repair of a unilateral inguinal hernia underwent random allocation into one of the four groups to receive: bupivacaine and papaveretum-aspirin (group 1), bupivacaine and oral placebo (group 2), saline and papaveretum-aspirin (group 3), or saline and oral placebo (group 4). Patients were prescribed postoperative opiates to be given on demand. Pain levels and mobility were assessed at 6 and 24 h after operation. Patients in group 1 reported significantly less pain, required less additional opiates and had better mobility than those in group 4 (pain score P < 0.001 at 6 h and P = 0.002 at 24 h) and group 3 (P = 0.002 for pain and mobility scores at 6 h). Bupivacaine alone provided good immediate postoperative pain relief (P = 0.002 group 2 versus group 4 at 6 h). The combination of bupivacaine and papaveretum-aspirin provided the best results and is suitable for day-case postoperative analgesia.

Effect of preincisional ilioinguinal and iliohypogastric nerve block on postoperative analgesic requirement in day‐surgery patients undergoing herniorrhaphy under spinal anaesthesia

“…for the duration of the study period. In fact, a similar beneficial immediate effect of the local anaesthetic infiltration has been observed by Nehra et al (14) and was observed now by us, too. In the study by Ejlersen et al (3), the exact duration of the analgesia induced by the infiltration block beyond the time of discharge remains open, but it seems to have exceeded the duration of the lignocaine infiltration block.…”

Preperitoneal bupivacaine attenuates pain following laparoscopic inguinal hernia repair

“…[3,9,10]. However, in the case of laparoscopic hernia repair, the dose to the preperitoneal space cannot be administered prior to tissue dissection, thus precluding preemptive anesthesia.…”

Laparoscopic vs open inguinal hernia repair A randomized, controlled trial

“…Laparoscopic hernia repair is an option for patients who have no contraindications and are willing to pay the extra cost in exchange for less postoperative pain, less disability, and earlier return to normal activities. Admittedly, the infiltration of long-acting local anesthetic into the incisional wound after an open repair and the use of stronger analgesics in the postoperative period could reduce or even nullify the advantages of laparoscopic repair [13], but this has yet to be proved in a randomized trial. We currently advise laparoscopic repair for patients with bilateral hernias since the postoperative pain and disability were found to be much less than simultaneous bilateral open repair, although we could not provide any statistical proof due to the small number of patients in this subgroup.…”