title: Prospective double-blind randomised study of a new regimen of pre-emptive analgesia for inguinal hernia repair: evaluation of postoperative pain course.
abstract: OBJECTIVE
  To evaluate the effectiveness of a new regimen of pre-emptive analgesia on the development of postoperative pain after inguinal hernia repair.
  
  
  METHODS
  Prospective, double-blind, randomised study.
  
  
  METHODS
  University Hospital, Germany.
  
  
  METHODS
  70 consecutive patients who had primary unilateral inguinal hernia repairs.
  
  
  METHODS
  A new regimen of pre-emptive analgesia with bupivacaine that was infiltrated preoperatively, intraoperatively, and postoperatively was tested. The control group were given saline infiltrations at the same times. Pain was measured up to postoperative day 30 using the visual analogue scale (VAS), the verbal rating scale (VRS), and by recording patient-controlled use of ibuprofen suppositories.
  
  
  RESULTS
  Pain was significantly less in the pre-emptive analgesia group than in the control group during the first 10 days postoperatively as assessed by VAS and VRS (p < 0.05). Analgesic consumption was also significantly reduced in the pre-emptive analgesia group (p < 0.05). Multivariate analysis showed that bupivacaine infiltration (pre-emptive analgesia) was associated with significantly less postoperative pain (p < 0.0001).
  
  
  CONCLUSIONS
  This regimen of pre-emptive analgesia is an effective and safe method of reducing postoperative pain and analgesic consumption after inguinal hernia repair.
authors.affiliation: Second Department of Surgery, University of Cologne, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Fischer
authors.forename: H
authors.initials: H
authors.lastname: Troidl
authors.forename: A A
authors.initials: AA
authors.lastname: MacLean
authors.forename: L
authors.initials: L
authors.lastname: Koehler
authors.forename: A
authors.initials: A
authors.lastname: Paul
mesh_terms: D000328:Adult; D000368:Aged; D000698:Analgesia / Q000379:methods*; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002045:Bupivacaine / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D011292:Premedication; D011446:Prospective Studies; D013488:Suppositories
chemical_list: D018712:Analgesics, Non-Narcotic; D000779:Anesthetics, Local; D013488:Suppositories; D007052:Ibuprofen; D002045:Bupivacaine