The Use of Bupivacaine in Elective Inguinal Herniorrhaphy as a Fast and Safe Technique for Relief of Postoperative Pain

Bays, Ronald A.; Barry, Laura A; Vasilenko, Peter

doi:10.1097/00132586-199206000-00044

Cited by 10 publications

(14 citation statements)

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“…Compared with placebo and no treatment, instillation with bupivacaine alone was superior for reducing pain scores at 1, 3, 5 and 7 h ( P = 0·05), but not at 9, 12, 16 or 20 h, whereas instillation with bupivacaine plus adrenaline was superior at 1, 3, 5, 7, 9 and 12 h ( P = 0·02), but not at 16 or 20 h48. Lidocaine spray was superior ( P < 0·050) for reducing pain scores at rest during the first 24 h, but not on day 2; lidocaine spray was superior to no treatment ( P < 0·050), but not placebo, for reducing pain on movement at 12–14 h49.…”

Section: Pharmacological Interventionsmentioning

confidence: 93%

“…Two studies compared LA instillation in the surgical wound at the end of surgery with placebo or no treatment in the following regimens: bupivacaine 0·5 per cent with, or without adrenaline (epinephrine) 1:200 000 (5 ml applied along the spermatic cord, 5 ml instilled into the wound after closure of the external oblique aponeurosis superficial to cord structures and 5 ml instilled subcutaneously before the end of skin closure) versus placebo and no treatment ( n = 10 in each group)48; and lidocaine 200 mg, 2 ml sprayed evenly on the subcutaneous surface of the wound before skin closure versus placebo (saline spray) or no treatment ( n = 10 in each group)49.…”

Section: Pharmacological Interventionsmentioning

confidence: 99%

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Evidence-based management of postoperative pain in adults undergoing open inguinal hernia surgery

Joshi

Rawal

Kehlet

2012

Journal of British Surgery

124

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Field block with, or without wound infiltration, either as a sole anaesthetic/analgesic technique or as an adjunct to general anaesthesia, is recommended to reduce postoperative pain. Continuous local anaesthetic infusion of a surgical wound provides a longer duration of analgesia. Conventional non-steroidal anti-inflammatory drugs or cyclo-oxygenase 2-selective inhibitors in combination with paracetamol, administered in time to provide sufficient analgesia in the early recovery phase, are optimal. In addition, weak opioids are recommended for moderate pain, and strong opioids for severe pain, on request.

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Section: Pharmacological Interventionsmentioning

confidence: 93%

Section: Pharmacological Interventionsmentioning

confidence: 99%

Evidence-based management of postoperative pain in adults undergoing open inguinal hernia surgery

Joshi

Rawal

Kehlet

2012

Journal of British Surgery

124

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“…10,11,13 Present study is designed to evaluate the effect of intraperitoneal instillation of 0.5% bupivacaine with adrenaline for pain relief following laparoscopic cholecystectomy.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of postoperative pain relief with intra-peritoneal bupivacaine instillation in laparoscopic cholecystectomy- a randomized control study

Agrawal

Pai

2017

Int Surg J

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Background: Laparoscopic cholecystectomy is the surgical procedure of choice for symptomatic cholelithiasis due to the improved postoperative course, but patients undergoing laparoscopic cholecystectomy during the first 24 hours postoperatively complaints of pain. This study was designed to study the efficacy of intraperitoneal bupivacaine in reducing the initial postoperative pain and also to evaluate the postoperative shoulder tip pain, nausea and vomiting.Methods: Patients undergoing laparoscopic cholecystectomy were randomized into two groups the, study group received intraperitoneal bupivacaine 100mg at the end of the procedure and the control group received intraperitoneal saline. Post operatively patients were assessed for pulse rate, blood pressure, VAS, VRS, shoulder pain and nausea and vomiting at 0, 2, 6 and 24 hours.Results: Among the 50 patients studied, our study proved that there is no statistical significant reduction in pain with intraperitoneal bupivacaine. The VAS at 0, 2, 6 and 24 hours calculated with non-significant p-value of 0.85,0.29, 0.72 and 0.64 respectively and the VRS had p-value of 0.16, 0.08, 0.59 and 0.46 respectively and the doses of rescue analgesia consumed had p value of 0 .67, 0.61 and 0.70 which were not significant statistically.Conclusions: Instillation of 100mg bupivacaine did not significantly reduce the need for tramadol compared with saline.

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“…Similarly, several previous trials have shown that LA infiltration only decrease immediate postoperative pain scores within several h postoperatively compared with placebo or no intervention in inguinal herniorrhaphy [12], breast surgery [13], hip arthroplasty [14], and caesarean section [15].…”

Section: Discussionmentioning

confidence: 67%

Ultrasound-guided TAP Block with or without Dexmedetomidine vs. Local Infiltration of the Wound after Open Herniorrhaphy: A Randomized Prospective Controlled Study

Eldegwy¹,

Alfkey²

2017

J Anesth Clin Res

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Objectives: Transversus abdominis plane (TAP) block and local anesthetic wound infiltration (LAI) can provide a variable effective pain relief at the wound site after surgery. This prospective study was designed to evaluate the postoperative analgesic efficacy of TAP with or without dexmedetomidine compared with LAI of the wound after herniorrhaphy. Materials and methods:Sixty adult patients were divided into 3 groups of 20 patients each. Group1 (TAPD): Patients received single shot ultrasound-guided (US) TAP block using 15 mL of levobupivacaine 0.5% mixed with 0.9 μg/kg of dexmedetomidine. Group 2 (TAP): Patients received single shot US guided TAP block using 15 mL of levobupivacaine 0.5%. Group 3 (LAI): Patients received local anesthetic infiltration (LAI) patients received local infiltration using 15 mL of levobupivacaine 0.5%. The following parameters were assessed at, 2, 10, 18 and 24 h postoperatively: postoperative duration of analgesia, analgesic pain scores using the visual analogue scale (VAS) for pain, amount of supplemental intravenous morphine, postoperative nausea and vomiting during 24 h. Results:We found that a lower significant difference (P<0.05) of VAS pain scores at rest and on movement between group TAPD and group TAP at time 24 h postoperatively. Also, there was a lower significant difference (P<0.05) of VAS pain scores at rest and on movement between group TAPD and group LAI at 10, 18 and 24 h. Moreover, there was a lower significant difference (P<0.05) between group TAP and group LAI at times 10 and 18 h. Also, supplemental morphine consumption within 24 h was a statistically higher (P<0.05) in group LAI compared to groups TAPD and TAP. Conclusion:Using dexmedetomidine as an additive to levobupivacaine in ultrasound-guided TAP block for herniorrhaphy provides prolonged duration of postoperative analgesia, and lowered VAS pain scores. Also local anesthetic infiltration can give accepted postoperative analgesia but with shorter duration than TAP block

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The Use of Bupivacaine in Elective Inguinal Herniorrhaphy as a Fast and Safe Technique for Relief of Postoperative Pain

Cited by 10 publications

References 0 publications

Evidence-based management of postoperative pain in adults undergoing open inguinal hernia surgery

Evidence-based management of postoperative pain in adults undergoing open inguinal hernia surgery

Evaluation of postoperative pain relief with intra-peritoneal bupivacaine instillation in laparoscopic cholecystectomy- a randomized control study

Ultrasound-guided TAP Block with or without Dexmedetomidine vs. Local Infiltration of the Wound after Open Herniorrhaphy: A Randomized Prospective Controlled Study

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