title: Subcutaneously versus subfascially administered lidocaine in pain treatment after inguinal herniotomy.
abstract: We conducted a randomized, prospective, double-blind trial to compare the efficacy of subfascial (SF) versus subcutaneous (SC) lidocaine (10 mL 1%) given in the wound postoperatively through a catheter placed in the respective layer intraoperatively. The initial pain scores were similar in the two groups before injection of lidocaine. In the SC group, there was a reduction in pain scores during rest from 4 to 3 (P > 0.05), during cough from 6 to 5 (P > 0.05), and during mobilization from 7 to 5.5 (P > 0.05) at 15 min. In the SF group, the reductions in pain scores were from 4 to 2 (P < 0.05), from 6 to 3 (P < 0.05), and from 7 to 3 (P < 0.05), respectively. Supplemental analgesics after the lidocaine administration were needed earlier in the SC group than in the SF group (P < 0.01). We conclude that postoperative pain treatment with local lidocaine application after herniotomy has a better effect when applied in the SF, rather than the SC, layer.
authors.affiliation: Department of Anaesthesia, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
authors.forename: S
authors.initials: S
authors.lastname: Yndgaard
authors.forename: P
authors.initials: P
authors.lastname: Holst
authors.forename: K
authors.initials: K
authors.lastname: Bjerre-Jepsen
authors.forename: C B
authors.initials: CB
authors.lastname: Thomsen
authors.forename: J
authors.initials: J
authors.lastname: Struckmann
authors.forename: T
authors.initials: T
authors.lastname: Mogensen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D005205:Fascia; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007267:Injections / Q000379:methods; D007279:Injections, Subcutaneous; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D008012:Lidocaine