title: Repeated boluses of local anaesthetic for pain relief after inguinal hernia repair.
abstract: 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.
authors.affiliation: Department of Surgery, Charité, Humboldt University of Berlin, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Zieren
authors.forename: H U
authors.initials: HU
authors.lastname: Zieren
authors.forename: C A
authors.initials: CA
authors.lastname: Jacobi
authors.forename: J M
authors.initials: JM
authors.lastname: Müller
mesh_terms: 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
chemical_list: D000700:Analgesics; D000779:Anesthetics, Local