Postoperative analgesia after inguinal hernia repair - Comparison of ropivacaine with bupivacaine: A randomized controlled trial

Abstract

Background:Postoperative pain management by surgical site infiltration has an edge over other methods of analgesia as it is simple and has lesser side effects. This study was designed to compare the analgesic effects provided by bupivacaine, a classical long-acting local anesthetic and ropivacaine, a new amino amide local anesthetic agent.Subjects and Methods:Ninety patients scheduled for elective inguinal herniorrhaphy were randomly allocated to one of the three groups: Group I - R 0.5, group II - R 0.25, and group III - B 0.25. General anesthesia was given. The surgical site was infiltrated before incision with 20 ml of drugs - ropivacaine 0.5% in group I, ropivacaine 0.25% in group II, bupivacaine 0.25% in group III. Intraoperatively hemodynamics were recorded every 15 min until the end of surgery and at the time of skin incision, at the time of cord pulling, and at the time of skin closure. Postoperatively, rest pain, pain on coughing, and pain on movements were assessed using visual analog scale (VAS) score immediately at the end of the surgery and hourly up to 4 h. The time of the first request for rescue analgesia was noted.Results:VAS scores at rest, during coughing and movements were higher in group R 0.25 and the time of rescue analgesia was shorter with group R 0.25 when compared with other groups.Conclusion:Ropivacaine is less potent than bupivacaine at equal concentrations.

Comparison between Post-Operative Analgesic Efficacy of Low-Concentration High-Volume and High-Concentration Low-Volume Combinations of Ropivacaine for Transverse Abdominis Plane Block in Pediatric Open Inguinal Hernia Repair

“…In the current study, TAP block with 1 mg/kg of 0.25% ropivacaine successfully provided pain relief in 87% of the pediatric patients immediately after surgery, and reduced the need for fentanyl at PACU by 67%. Limited studies have investigated the effect of different concentrations and volumes of local anesthetics in regional anesthesia [11,12,13]. In children undergoing orchiopexy, caudal block, with a large volume of diluted ropivacaine, provided better quality and a longer duration of analgesia than a small volume of concentrated ropivacaine [8].…”

“…Although, a higher dose of local anesthetics for regional nerve block provides prolonged relief from post-operative pain and decreases the need for rescue analgesics [12,13], it is worthwhile to investigate the optimal concentration and volume for the same dosage of local anesthetics owing to a perennial risk of overdose, due to local anesthetics, especially in pediatric patients.…”

Comparison of Tramadol Versus Bupivacaine as Local Anesthetic in Pain Control in Inguinal Hernia Surgery

“…Early discharge from hospital and significant analgesic effect is observed in all conducted studies. 8,9 Studies have likewise demonstrated prolong analgesic effect with the use of inguinal local infiltration along with decline in the usage of systemic analgesia after surgery. 10 The satisfaction of patient was also substantial.…”