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Erschienen in: Surgical Endoscopy 7/2004

01.07.2004 | Original article

Preperitoneal bupivacaine attenuates pain following laparoscopic inguinal hernia repair

verfasst von: A. Bar-Dayan, M. Natour, B. Bar-Zakai, O. Zmora, M. Shabtai, A. Ayalon, J. Kuriansky

Erschienen in: Surgical Endoscopy | Ausgabe 7/2004

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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.

Conclusion

Preperitoneal Bupivacaine attenuates pain following laparoscopic inguinal hernia repair and should be considered in these cases.
Literatur
1.
Zurück zum Zitat Bays, A, Barry, L, Vasilenko, P 1991The use of Bupivacaine in elective inguinal herniorrhaphy as a fast and safe technique for relief of postoperative pain.Surg Gynecol Obstet173433437PubMed Bays, A, Barry, L, Vasilenko, P 1991The use of Bupivacaine in elective inguinal herniorrhaphy as a fast and safe technique for relief of postoperative pain.Surg Gynecol Obstet173433437PubMed
2.
Zurück zum Zitat Deans, G, Wilson, S, Brough, A 1998Controlled trial of preperitoneal local anesthetic for reducing pain following laparoscopic hernia repair.Br J Surg8510131014CrossRefPubMed Deans, G, Wilson, S, Brough, A 1998Controlled trial of preperitoneal local anesthetic for reducing pain following laparoscopic hernia repair.Br J Surg8510131014CrossRefPubMed
3.
Zurück zum Zitat Dierking, WJ, Ostergard, TH, Dahl, BJ 1994The effect of wound infiltration with Bupivacaine versus saline on postoperative pain and opioid requirements after herniorraphy.Acta Anaesthesiol Scand38289292PubMed Dierking, WJ, Ostergard, TH, Dahl, BJ 1994The effect of wound infiltration with Bupivacaine versus saline on postoperative pain and opioid requirements after herniorraphy.Acta Anaesthesiol Scand38289292PubMed
4.
Zurück zum Zitat Edelman, SD, Misiakos, PF, Moses, K 2001Extraperitoneal laparoscopic hernia repair with local anesthesia.Surg Endosc101007 Edelman, SD, Misiakos, PF, Moses, K 2001Extraperitoneal laparoscopic hernia repair with local anesthesia.Surg Endosc101007
5.
Zurück zum Zitat Harrison, AC, Morris, S, Harvey, SJ 1994Effect of ilioinguinal and iliohypogastric nerve block and wound infiltration with 0.5% Bupivacaine on postoperative pain after hernia repair.Br J Anaesthesiol72691693 Harrison, AC, Morris, S, Harvey, SJ 1994Effect of ilioinguinal and iliohypogastric nerve block and wound infiltration with 0.5% Bupivacaine on postoperative pain after hernia repair.Br J Anaesthesiol72691693
6.
Zurück zum Zitat Johansson, B, Hallerback, B, Stubberod, A, Janbu, T, Edwin, B, Glise, H, Solhaug, J 1997Preoperative local infiltration with Ropivacaine for postoperative pain relief after inguinal hernia repair.Eur J Surg163371378PubMed Johansson, B, Hallerback, B, Stubberod, A, Janbu, T, Edwin, B, Glise, H, Solhaug, J 1997Preoperative local infiltration with Ropivacaine for postoperative pain relief after inguinal hernia repair.Eur J Surg163371378PubMed
7.
Zurück zum Zitat Jual, P, Christensen, K 1999Randomized clinical trial of laparoscopic versus open inguinal hernia repair.Br J Surg86316319CrossRefPubMed Jual, P, Christensen, K 1999Randomized clinical trial of laparoscopic versus open inguinal hernia repair.Br J Surg86316319CrossRefPubMed
8.
Zurück zum Zitat Katkhouda, N, Campos, GM, Mavor, E, Trussler, A, Khalil, M, Stoppa, R 1999Laparoscopic extraperitoneal inguinal hernia repair. A safe approach based on the understanding of rectus sheath anatomy.Surg Endosc1212431246 Katkhouda, N, Campos, GM, Mavor, E, Trussler, A, Khalil, M, Stoppa, R 1999Laparoscopic extraperitoneal inguinal hernia repair. A safe approach based on the understanding of rectus sheath anatomy.Surg Endosc1212431246
9.
Zurück zum Zitat Nehra, D, Gemmel, L, Pye, K 1995Pain relief after inguinal hernia repair: a randomized double-blind study.Br J Surg8212451247PubMed Nehra, D, Gemmel, L, Pye, K 1995Pain relief after inguinal hernia repair: a randomized double-blind study.Br J Surg8212451247PubMed
10.
Zurück zum Zitat Oakley, MJ, Smith, ST, Anderson, RJ, Fenton Lee, D 1998Randomized placebo-controlled trial of local anaesthetic infusion in day case inguinal hernia repair.Br J Surg85797799CrossRefPubMed Oakley, MJ, Smith, ST, Anderson, RJ, Fenton Lee, D 1998Randomized placebo-controlled trial of local anaesthetic infusion in day case inguinal hernia repair.Br J Surg85797799CrossRefPubMed
11.
Zurück zum Zitat O’Riordain, DS, Kelly, P, Horgan, PG, Horgan, PG, Keane, BV, Tanner, WA 1998A randomized controlled trial of extraperitoneal Bupivacaine analgesia in laparoscopic hernia repair.Am J Surg176254257CrossRefPubMed O’Riordain, DS, Kelly, P, Horgan, PG, Horgan, PG, Keane, BV, Tanner, WA 1998A randomized controlled trial of extraperitoneal Bupivacaine analgesia in laparoscopic hernia repair.Am J Surg176254257CrossRefPubMed
12.
Zurück zum Zitat O’Riordain, DS, Kelly, P, Horgan, PG, Keane, FB, Tanner, WA 1999Laparoscopic extraperitoneal inguinal hernia repair in day-care setting.Surg Endosc13914917CrossRefPubMed O’Riordain, DS, Kelly, P, Horgan, PG, Keane, FB, Tanner, WA 1999Laparoscopic extraperitoneal inguinal hernia repair in day-care setting.Surg Endosc13914917CrossRefPubMed
13.
Zurück zum Zitat Rudkin, GE, Maddern, GJ 1995Peri-operative outcome for day-case laparoscopic and open inguinal hernia repair.Anasthesia50586589 Rudkin, GE, Maddern, GJ 1995Peri-operative outcome for day-case laparoscopic and open inguinal hernia repair.Anasthesia50586589
14.
Zurück zum Zitat Saff, NG, Marks, AR, Kuroda, M, Rozan, PJ, Hertz, R 1998Analgesic effect of Bupivacaine on extraperitoneal laparoscopic hernia repair.Anesth Analg87377381PubMed Saff, NG, Marks, AR, Kuroda, M, Rozan, PJ, Hertz, R 1998Analgesic effect of Bupivacaine on extraperitoneal laparoscopic hernia repair.Anesth Analg87377381PubMed
15.
Zurück zum Zitat Schrenk, P, Woisetschlager, R, Rieger, R, Wayand, W 1996Prospective randomized trial comparing postoperative pain and return to physical activity after transabdominal preperitoneal, total preperitoneal or shouldice technique for inguinal hernia repair.Br J Surg8315631566PubMed Schrenk, P, Woisetschlager, R, Rieger, R, Wayand, W 1996Prospective randomized trial comparing postoperative pain and return to physical activity after transabdominal preperitoneal, total preperitoneal or shouldice technique for inguinal hernia repair.Br J Surg8315631566PubMed
16.
Zurück zum Zitat Shenfeld, O, Eldar, I, Lotan, G, Avigad, I, Goldwasser, B 1995Intraoperative irrigation with Bupivacaine for analgesia after orchiopexy and herniorrhaphy in children.J Urol153185187CrossRefPubMed Shenfeld, O, Eldar, I, Lotan, G, Avigad, I, Goldwasser, B 1995Intraoperative irrigation with Bupivacaine for analgesia after orchiopexy and herniorrhaphy in children.J Urol153185187CrossRefPubMed
17.
Zurück zum Zitat Szem, WJ, Hydo, L, Barie, SP 1996A double-blinded evaluation of intraperitoneal Bupivacaine vs saline for the reduction of postoperative pain and nausea after laparoscopic cholecystectomy.Surg Endosc104448CrossRefPubMed Szem, WJ, Hydo, L, Barie, SP 1996A double-blinded evaluation of intraperitoneal Bupivacaine vs saline for the reduction of postoperative pain and nausea after laparoscopic cholecystectomy.Surg Endosc104448CrossRefPubMed
18.
Zurück zum Zitat Tsimoyiannis, CE, Glantzounis, G, Lekkas, TE, Siakas, P, Jabarin, M, Tzourou, H 1998Intraperitoneal normal saline and Bupivacaine infusion for reduction of postoperative pain after laparoscopic cholecystectomy.Surg Laparosc Endosc8416420CrossRefPubMed Tsimoyiannis, CE, Glantzounis, G, Lekkas, TE, Siakas, P, Jabarin, M, Tzourou, H 1998Intraperitoneal normal saline and Bupivacaine infusion for reduction of postoperative pain after laparoscopic cholecystectomy.Surg Laparosc Endosc8416420CrossRefPubMed
19.
Zurück zum Zitat Tverskoy, M, Cozacov, C, Ayache, M, Bradley, EL, Kissin, I 1990Postoperative pain after hemiorrhaphy with different types of anesthesia.Anesth Analg702935PubMed Tverskoy, M, Cozacov, C, Ayache, M, Bradley, EL, Kissin, I 1990Postoperative pain after hemiorrhaphy with different types of anesthesia.Anesth Analg702935PubMed
20.
Zurück zum Zitat Zmora, O, Dollberg, SO, Bar-Zakai, B, Rosin, D, Kuriansky, J, Shabtai, M, Perel, A, Ayalon, A 2000Intraperitoneal Bupivacaine does not attenuate pain following laparoscopic cholecystectomy.J Surg Laparoendosc4301304 Zmora, O, Dollberg, SO, Bar-Zakai, B, Rosin, D, Kuriansky, J, Shabtai, M, Perel, A, Ayalon, A 2000Intraperitoneal Bupivacaine does not attenuate pain following laparoscopic cholecystectomy.J Surg Laparoendosc4301304
Metadaten
Titel
Preperitoneal bupivacaine attenuates pain following laparoscopic inguinal hernia repair
verfasst von
A. Bar-Dayan
M. Natour
B. Bar-Zakai
O. Zmora
M. Shabtai
A. Ayalon
J. Kuriansky
Publikationsdatum
01.07.2004
Erschienen in
Surgical Endoscopy / Ausgabe 7/2004
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-003-8214-x

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