A Randomized Controlled Trial of Preperitoneal Bupivacaine Instillation for Reducing Pain Following Laparoscopic Inguinal Herniorrhaphy

The efficacy of bupivacaine instillation into preperitoneal space following laparoscopic herniorrhaphy for postoperative pain reduction is still in controversy. A randomized controlled trial was conducted to determine the efficacy of bupivacaine instillation. The 40 patients, who had an inguinal her...

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Bibliographic Details
Published in:Surgical innovation 2009-06, Vol.16 (2), p.117-123
Main Authors: Suvikapakornkul, Ronnarat, Valaivarangkul, Panisara, Noiwan, Patcharee, Phansukphon, Thanin
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anesthetics, Local - administration & dosage
Bupivacaine - administration & dosage
Female
Follow-Up Studies
Hernia, Inguinal - surgery
Humans
Instillation, Drug
Laparoscopy - adverse effects
Male
Middle Aged
Pain Measurement
Pain, Postoperative - etiology
Pain, Postoperative - prevention & control
Peritoneal Cavity
Treatment Outcome
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Summary:The efficacy of bupivacaine instillation into preperitoneal space following laparoscopic herniorrhaphy for postoperative pain reduction is still in controversy. A randomized controlled trial was conducted to determine the efficacy of bupivacaine instillation. The 40 patients, who had an inguinal hernia with no complication, unilateral or bilateral and recurrence or no recurrence after previous hernia repair, were randomly assigned to receive bupivacaine (n = 19) and normal saline (n = 21). The intervention or placebo was instilled into the preperitoneal space after total extraperitoneal laparoscopic herniorrhaphy. Pain intensity was assessed by using a visual analogue scale and verbal rating scale after the 1st, 2nd, 6th, 12th, and 24th hour postoperatively. For the bupivacaine and placebo group, mean pain scores were 3.5 versus 5.2 (P = .059), 2.9 versus 4.5 (P = .117), 2.1 versus 3.2 (P = .101), 1.5 versus 2.7 (P = .145), and 1.6 versus 2.0 (P = .672) after the 1st, 2nd, 6th, 12th, and 24th hour, respectively. Complications developed in 4 patients in the bupivacaine group and 7 patients in the placebo group after 3 months follow-up time. There is no strong evidence to confirm that bupivacaine instillation into preperitoneal space after laparoscopic herniorrhaphy can reduce postoperative pain.
ISSN:1553-3506
1553-3514
DOI:10.1177/1553350609334128