The novel use of different bupivacaine preparations with combined regional techniques for postoperative pain management in non-opioid-based laparoscopic inguinal herniorrhaphy.
Opioids are important for surgical pain control but may not be appropriate for patients with narcotic abuse histories or opioid intolerance. We describe a laparoscopic bilateral inguinal herniorrhaphy performed without perioperative or postoperative narcotics. Postoperative analgesia involves a novel technique using 2 different bupivacaine formulations that act synergistically to avoid lag time and provide extended pain relief during the acute surgical recovery phase.
Department of Surgery, Division of General Surgery, Richard L. Roudebush VA Medical Center, Indiana University School of Medicine, 1481 West Tenth Street, Indianapolis, IN 46202, USA. Electronic address: aeppstei@iupui.edu.
Andrew C
AC
Eppstein
Department of Anesthesiology, Richard L. Roudebush VA Medical Center, Indiana University School of Medicine, 1481 West Tenth Street, Indianapolis, IN 46202, USA. Electronic address: bryan.sakamoto@va.gov.
Bryan
B
Sakamoto
D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000627:therapeutic use; D000768:Anesthesia, General / Q000379:methods; D000772:Anesthesia, Local / Q000379:methods*; D000775:Anesthesia, Spinal; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use; D001279:Atracurium / Q000008:administration & dosage / Q000031:analogs & derivatives; D002045:Bupivacaine / Q000008:administration & dosage* / Q000627:therapeutic use*; D004357:Drug Synergism; D006552:Hernia, Inguinal / Q000601:surgery; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008081:Liposomes; D008297:Male; D008875:Middle Aged; D019148:Neuromuscular Blockade / Q000379:methods; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy*
D018712:Analgesics, Non-Narcotic; D000779:Anesthetics, Local; D008081:Liposomes; D001279:Atracurium; C101584:cisatracurium; D002045:Bupivacaine
Hernia, inguinal; Herniorrhaphy; Laparoscopy; Narcotics; Nerve block; Pain, postoperative