title: Preperitoneal bupivacaine attenuates pain following laparoscopic inguinal hernia repair.
abstract: BACKGROUND
  Laparoscopic preperitoneal inguinal hernia repair is associated with a short hospital stay and an early return to normal activity. Therefore, early postoperative pain control is important. The aim of this study was to evaluate the effect of preperitoneal Bupivacaine instilled into the preperitoneal cavity on pain following laparoscopic mesh repair of inguinal hernia.
  
  
  METHODS
  After institutional review board approval, 44 patients undergoing elective laparoscopic inguinal hernia repair were prospectively randomized into two groups. Upon completion of the Prolene mesh repair, group A received 80 mg of Bupivacaine in 25 cc of saline installed into the preperitoneal space, whereas group B received normal saline installed into the preperitoneal space. Pain was assessed using a visual analog scale at fixed time intervals; the amount of analgesics required was also recorded.
  
  
  RESULTS
  Twenty-two patients were included in each group. The demographic characteristics and type of surgery (unilateral vs bilateral) did not significantly differ between the two groups. The average pain levels were significantly attenuated in group A compared to group B at 1 (4.0 vs 5.0, respectively; p = 0.0038), 2 (4.0 vs 5.9, respectively; p = 0.0015), and 4 (4.3 vs 5.8, respectively; p = 0.0038) h after surgery. Furthermore, the analgesic intake was significantly decreased in group A compared to group B.
  
  
  CONCLUSIONS
  Preperitoneal Bupivacaine attenuates pain following laparoscopic inguinal hernia repair and should be considered in these cases.
authors.affiliation: Department of Surgery, Sheba Medical Center, Sackler School of Medicine, Tel Aviv, Israel. bar-d@zahav.net.il
authors.forename: A
authors.initials: A
authors.lastname: Bar-Dayan
authors.forename: M
authors.initials: M
authors.lastname: Natour
authors.forename: B
authors.initials: B
authors.lastname: Bar-Zakai
authors.forename: O
authors.initials: O
authors.lastname: Zmora
authors.forename: M
authors.initials: M
authors.lastname: Shabtai
authors.forename: A
authors.initials: A
authors.lastname: Ayalon
authors.forename: J
authors.initials: J
authors.lastname: Kuriansky
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007322:Instillation, Drug; D010535:Laparoscopy; D008614:Meperidine / Q000627:therapeutic use; D010098:Oxycodone / Q000627:therapeutic use; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D010529:Peritoneal Cavity; D011446:Prospective Studies; D013526:Surgical Mesh
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D008614:Meperidine; D010098:Oxycodone; D002045:Bupivacaine