This Article Full Text (PDF) All Versions of this Article: 1553350609334128v1 16/2/117    most recent References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Scopus Google Scholar Articles by Suvikapakornkul, R. Articles by Phansukphon, T. PubMed PubMed Citation Articles by Suvikapakornkul, R. Articles by Phansukphon, T. Social Bookmarking                         What's this?

A Randomized Controlled Trial of Preperitoneal Bupivacaine Instillation for Reducing Pain Following Laparoscopic Inguinal Herniorrhaphy

Department of Surgery, Ramathibodi Hospital, Mahidol University, Phyathai, Bangkok, Thailand, tersv{at}mahidol.ac.th

Panisara Valaivarangkul, BNS

Department of Nursing, Ramathibodi Hospital, Mahidol University, Phyathai, Bangkok, Thailand

Patcharee Noiwan, BNS

Department of Nursing Ramathibodi Hospital, Mahidol University, Phyathai, Bangkok, Thailand

Thanin Phansukphon, MD

Department of Surgery, Ramathibodi Hospital, Mahidol University, Phyathai, Bangkok, Thailand

The efficacy of bupivacaine instillation into preperitoneal space following laparoscopic herniorrhaphy for postoperative pain reduction is still in controversy. A randomized controlled trial was conducted to determine the efficacy of bupivacaine instillation. The 40 patients, who had an inguinal hernia with no complication, unilateral or bilateral and recurrence or no recurrence after previous hernia repair, were randomly assigned to receive bupivacaine (n = 19) and normal saline (n = 21). The intervention or placebo was instilled into the preperitoneal space after total extraperitoneal laparoscopic herniorrhaphy. Pain intensity was assessed by using a visual analogue scale and verbal rating scale after the 1st, 2nd, 6th, 12th, and 24th hour postoperatively. For the bupivacaine and placebo group, mean pain scores were 3.5 versus 5.2 (P = .059), 2.9 versus 4.5 (P = .117), 2.1 versus 3.2 (P = .101), 1.5 versus 2.7 (P = .145), and 1.6 versus 2.0 (P = .672) after the 1st, 2nd, 6th, 12th, and 24th hour, respectively. Complications developed in 4 patients in the bupivacaine group and 7 patients in the placebo group after 3 months follow-up time. There is no strong evidence to confirm that bupivacaine instillation into preperitoneal space after laparoscopic herniorrhaphy can reduce postoperative pain.

Key Words: laparoscopic herniorrhaphy • pain • bupivacaine • randomized controlled trial

This version was published on June 1, 2009

Surgical Innovation, Vol. 16, No. 2, 117-123 (2009)
DOI: 10.1177/1553350609334128


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?