Abstract
Background
Laparoscopic preperitoneal inguinal hernia repair is associated with a short hospital stay and an early return to normal activity. Therefore, early postoperative pain control is important. The aim of this study was to evaluate the effect of preperitoneal Bupivacaine instilled into the preperitoneal cavity on pain following laparoscopic mesh repair of inguinal hernia.
Methods
After institutional review board approval, 44 patients undergoing elective laparoscopic inguinal hernia repair were prospectively randomized into two groups. Upon completion of the Prolene mesh repair, group A received 80 mg of Bupivacaine in 25 cc of saline installed into the preperitoneal space, whereas group B received normal saline installed into the preperitoneal space. Pain was assessed using a visual analog scale at fixed time intervals; the amount of analgesics required was also recorded.
Results
Twenty-two patients were included in each group. The demographic characteristics and type of surgery (unilateral vs bilateral) did not significantly differ between the two groups. The average pain levels were significantly attenuated in group A compared to group B at 1 (4.0 vs 5.0, respectively; p = 0.0038), 2 (4.0 vs 5.9, respectively; p = 0.0015), and 4 (4.3 vs 5.8, respectively; p = 0.0038) h after surgery. Furthermore, the analgesic intake was significantly decreased in group A compared to group B.
Conclusion
Preperitoneal Bupivacaine attenuates pain following laparoscopic inguinal hernia repair and should be considered in these cases.
Similar content being viewed by others
References
A Bays L Barry P Vasilenko (1991) ArticleTitleThe use of Bupivacaine in elective inguinal herniorrhaphy as a fast and safe technique for relief of postoperative pain. Surg Gynecol Obstet 173 433–437 Occurrence Handle1:STN:280:By2D2Mrit1Y%3D Occurrence Handle1948598
G Deans S Wilson A Brough (1998) ArticleTitleControlled trial of preperitoneal local anesthetic for reducing pain following laparoscopic hernia repair. Br J Surg 85 1013–1014 Occurrence Handle10.1046/j.1365-2168.1998.00763.x Occurrence Handle1:STN:280:DyaK1czlsFeitw%3D%3D Occurrence Handle9692587
WJ Dierking TH Ostergard BJ Dahl (1994) ArticleTitleThe effect of wound infiltration with Bupivacaine versus saline on postoperative pain and opioid requirements after herniorraphy. Acta Anaesthesiol Scand 38 289–292 Occurrence Handle1:STN:280:ByuB1MrjvVA%3D Occurrence Handle8023671
SD Edelman PF Misiakos K Moses (2001) ArticleTitleExtraperitoneal laparoscopic hernia repair with local anesthesia. Surg Endosc 10 1007
AC Harrison S Morris SJ Harvey (1994) ArticleTitleEffect of ilioinguinal and iliohypogastric nerve block and wound infiltration with 0.5% Bupivacaine on postoperative pain after hernia repair. Br J Anaesthesiol 72 691–693 Occurrence Handle1:STN:280:ByuB1MnotFQ%3D
B Johansson B Hallerback A Stubberod T Janbu B Edwin H Glise J Solhaug (1997) ArticleTitlePreoperative local infiltration with Ropivacaine for postoperative pain relief after inguinal hernia repair. Eur J Surg 163 371–378 Occurrence Handle1:STN:280:ByiA3sfmtFU%3D Occurrence Handle9195171
P Jual K Christensen (1999) ArticleTitleRandomized clinical trial of laparoscopic versus open inguinal hernia repair. Br J Surg 86 316–319 Occurrence Handle10.1046/j.1365-2168.1999.01053.x Occurrence Handle1:STN:280:DyaK1M3hsF2msQ%3D%3D Occurrence Handle10201770
N Katkhouda GM Campos E Mavor A Trussler M Khalil R Stoppa (1999) ArticleTitleLaparoscopic extraperitoneal inguinal hernia repair. A safe approach based on the understanding of rectus sheath anatomy. Surg Endosc 12 1243–1246
D Nehra L Gemmel K Pye (1995) ArticleTitlePain relief after inguinal hernia repair: a randomized double-blind study. Br J Surg 82 1245–1247 Occurrence Handle1:STN:280:BymD3s%2FktlY%3D Occurrence Handle7552008
MJ Oakley ST Smith RJ Anderson D Fenton Lee (1998) ArticleTitleRandomized placebo-controlled trial of local anaesthetic infusion in day case inguinal hernia repair. Br J Surg 85 797–799 Occurrence Handle10.1046/j.1365-2168.1998.00651.x Occurrence Handle1:STN:280:DyaK1czjtVartw%3D%3D Occurrence Handle9667711
DS O’Riordain P Kelly PG Horgan PG Horgan BV Keane WA Tanner (1998) ArticleTitleA randomized controlled trial of extraperitoneal Bupivacaine analgesia in laparoscopic hernia repair. Am J Surg 176 254–257 Occurrence Handle10.1016/S0002-9610(98)00151-2 Occurrence Handle1:CAS:528:DyaK1cXmvFGisro%3D Occurrence Handle9776153
DS O’Riordain P Kelly PG Horgan FB Keane WA Tanner (1999) ArticleTitleLaparoscopic extraperitoneal inguinal hernia repair in day-care setting. Surg Endosc 13 914–917 Occurrence Handle10.1007/s004649901133 Occurrence Handle1:STN:280:DyaK1MzotVKltg%3D%3D Occurrence Handle10449852
GE Rudkin GJ Maddern (1995) ArticleTitlePeri-operative outcome for day-case laparoscopic and open inguinal hernia repair. Anasthesia 50 586–589 Occurrence Handle1:STN:280:ByqA1c3jtVY%3D
NG Saff AR Marks M Kuroda PJ Rozan R Hertz (1998) ArticleTitleAnalgesic effect of Bupivacaine on extraperitoneal laparoscopic hernia repair. Anesth Analg 87 377–381 Occurrence Handle1:CAS:528:DyaK1cXlsFertbY%3D Occurrence Handle9706934
P Schrenk R Woisetschlager R Rieger W Wayand (1996) ArticleTitleProspective randomized trial comparing postoperative pain and return to physical activity after transabdominal preperitoneal, total preperitoneal or shouldice technique for inguinal hernia repair. Br J Surg 83 1563–1566 Occurrence Handle1:STN:280:ByiC28npvVI%3D Occurrence Handle9014675
O Shenfeld I Eldar G Lotan I Avigad B Goldwasser (1995) ArticleTitleIntraoperative irrigation with Bupivacaine for analgesia after orchiopexy and herniorrhaphy in children. J Urol 153 185–187 Occurrence Handle10.1097/00005392-199501000-00073 Occurrence Handle1:STN:280:ByqD2Mnit1I%3D Occurrence Handle7966769
WJ Szem L Hydo SP Barie (1996) ArticleTitleA double-blinded evaluation of intraperitoneal Bupivacaine vs saline for the reduction of postoperative pain and nausea after laparoscopic cholecystectomy. Surg Endosc 10 44–48 Occurrence Handle10.1007/s004649910011 Occurrence Handle1:STN:280:BymB28znvVc%3D Occurrence Handle8711605
CE Tsimoyiannis G Glantzounis TE Lekkas P Siakas M Jabarin H Tzourou (1998) ArticleTitleIntraperitoneal normal saline and Bupivacaine infusion for reduction of postoperative pain after laparoscopic cholecystectomy. Surg Laparosc Endosc 8 416–420 Occurrence Handle10.1097/00019509-199812000-00003 Occurrence Handle1:STN:280:DyaK1M%2FnvFyisg%3D%3D Occurrence Handle9864106
M Tverskoy C Cozacov M Ayache EL Bradley I Kissin (1990) ArticleTitlePostoperative pain after hemiorrhaphy with different types of anesthesia. Anesth Analg 70 29–35 Occurrence Handle1:STN:280:By%2BC38%2FgvVI%3D Occurrence Handle2297102
O Zmora SO Dollberg B Bar-Zakai D Rosin J Kuriansky M Shabtai A Perel A Ayalon (2000) ArticleTitleIntraperitoneal Bupivacaine does not attenuate pain following laparoscopic cholecystectomy. J Surg Laparoendosc 4 301–304 Occurrence Handle1:STN:280:DC%2BD3crgt1OntA%3D%3D
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bar-Dayan, A., Natour, M., Bar-Zakai, B. et al. Preperitoneal bupivacaine attenuates pain following laparoscopic inguinal hernia repair . Surg Endosc 18, 1079–1081 (2004). https://doi.org/10.1007/s00464-003-8214-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-003-8214-x