Repeated boluses of local anaesthetic for pain relief after inguinal hernia repair.
OBJECTIVE
To compare the effect of repeated boluses of local anaesthetics with an oral analgesic for pain management after tension-free inguinal hernia repair.


METHODS
Prospective randomised study.


METHODS
University hospital, Germany.


METHODS
104 patients undergoing elective hernia repair.


METHODS
52 patients were given boluses of 0.5% bupivacaine 10 ml through a subcutaneous catheter and 52 dipyrone 500 mg orally 6, 12 and 24 hours after operation.


METHODS
Postoperative pain measured on a visual analogue scale, complications, systemic side effects, supplementary analgesics, costs, and time taken to give the analgesics.


RESULTS
There were no significant differences between the groups in absolute pain scores, course of pain, and the effects of analgesics. Thirteen patients [5 in the bupivacaine group and 8 in the dipyrone group] required additional dipyrone [mean (range) 2000 mg (500-5000) and 2500 mg (500-4000) respectively]. There were no systemic side effects of either treatment. There were 5 wound haematomas in the bupivacaine group (10%), and 2 wound haematomas and 1 superficial wound infection in the dipyrone group (6%). Mean costs of material and time taken to give the analgesics were pound sterling 104.70 and 47 minutes in the bupivacaine group compared with pound sterling 3.40 and 6 minutes in the dipyrone group. The median (range) hospital stay was 2 (1-3) days in both groups.


CONCLUSIONS
Repeated boluses of local anaesthetic did not result in better or cheaper pain control than oral analgesics after tension-free inguinal hernia repair.
Zieren
J
J
Department of Surgery, Charité, Humboldt University of Berlin, Germany.
Zieren
H U
HU
Jacobi
C A
CA
Müller
J M
JM
D000700:Analgesics / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome
D000700:Analgesics; D000779:Anesthetics, Local