Local Anesthetic Infusion Pumps Improve Postoperative Pain After Inguinal Hernia Repair: A Randomized Trial

Sanchez, Barry; Waxman, Kenneth; Tatevossian, Raymond; Gamberdella, Marla; Read, Bruce
November 2004
American Surgeon;Nov2004, Vol. 70 Issue 11, p1002
Academic Journal
Pain after an open inguinal hernia repair may be significant. In fact, some surgeons feel that the pain after open repair justifies a laparoscopic approach. The purpose of this study was to determine if the use of local anesthetic infusion pumps would reduce postoperative pain after open inguinal hernia repair. We performed a prospective, double-blind randomized study of 45 open plug and patch inguinal hernia repairs. Patients were randomized to receive either 0.25 per cent bupivicaine or saline solution via an elastomeric infusion pump (ON-Q) for 48 hours, at 2 cc/h. The catheters were placed in the subcutaneous tissue and removed on postoperative day 3. Both groups were prescribed hydrocodone to use in the postoperative period at the prescribed dosage as needed for pain. Interviews were conducted on postoperative days 3 and 7, and patient's questionnaires, including pain scores, amount of pain medicine used, and any complications, were collected accordingly. During the first 5 postoperative days, postoperative pain was assessed using a visual analog scale. Twenty-three repairs were randomized to the bupivicaine group and 22 repairs randomized to the placebo group. In the bupivicaine group, there was a significant decrease in postoperative pain on postoperative days 2 through 5 with P values <0.05. This significant difference continued through postoperative day 5, 2 days after the infusion pumps were removed. Patients who had bupivicaine instilled in their infusion pump had statistically significant lower subjective pain scores on postoperative days 2 through 5. This significant difference continued even after the infusion pumps were removed. Local anesthetic infusion pumps significantly decreased the amount of early postoperative pain. Pain relief persisted for 2 days after catheter and pump removal.


Related Articles

  • Left laparoscopic paraduodenal hernia repair. Khalaileh, Abed; Schlager, Avraham; Bala, Miklosh; Abugazala, Samir; Elazary, Ram; Rivkind, Avraham I.; Mintz, Yoav // Surgical Endoscopy;Jun2010, Vol. 24 Issue 6, p1486 

    An internal hernia is a protrusion of bowel through a normal or abnormal orifice in the peritoneum or mesentery. Paraduodenal hernia is by far the most common form of congenital internal hernia, making up 53% of all reported cases. In recent years, as surgeons have become more comfortable with...

  • Radially expanding laparoscopic trocar ports significantly reduce postoperative pain in all age groups. Mordecai, Simon; Warren, Oliver; Warren, Stephen // Surgical Endoscopy;Mar2012, Vol. 26 Issue 3, p843 

    Background: Trocar entry points have been identified as a significant source of pain after laparoscopic surgery. This is particularly true of the larger 12-mm ports that require deep fascial closure to avoid port-site herniation. We investigated whether using radially expanding trocars not...

  • Laparoscopic parastomal hernia repair using a keyhole technique results in a high recurrence rate. Hansson, B. M. E.; Bleichrodt, R. P.; de Hingh, I. H. // Surgical Endoscopy;Jul2009, Vol. 23 Issue 7, p1456 

    Parastomal herniation is a common complication of stoma formation, and its operative treatment is notoriously difficult. Recently we have reported the promising short-term results of a keyhole technique in which a Gore-Tex Dual Mesh with a central keyhole is laparoscopically fashioned around the...

  • Evaluation of the mesh fixation technique in laparoscopic incisional hernioplasty. Moreno-Egea, A.; Torralba-Martínez, J. A.; Cuenca, G. M.; Baena, E. G.; la Calle, M. C.; Albasini, J. L. A. // Indian Journal of Surgery;Dec2005, Vol. 67 Issue 6, p332 

    The laparoscopic repair of incisional hernias still has controversial aspects, among which is the technique for mesh fixation to the posterior abdominal wall. Whereas some authors advocate single fixation with mechanical suture, others recommend a combined fixation of transmural sutures and...

  • Direct inguinal hernias in children: laparoscopic aspects. Schier, F. // Pediatric Surgery International;Nov2000, Vol. 16 Issue 8, p562 

    Among 109 children treated laparoscopically for inguinal hernias, 5 had direct hernias, more than would normally be anticipated. Two of the hernias were recurrences of indirect hernias operated upon previously using the open technique. Direct hernias are easier to detect with the laparoscopic...

  • A prospective cohort study comparing the African and European hernia. Sanders, D. L.; Porter, C. S.; Mitchell, K. C.; Kingsnorth, A. N. // Hernia;Oct2008, Vol. 12 Issue 5, p527 

    The prevalence of inguinal hernia in Ghana, western Africa, is as high as 7.7% of the population. The elective operation rate is significantly lower because many of the hernias are repaired as emergencies. This discrepancy results in a pool of longstanding large hernias. This prospective cohort...

  • Laparoscopic repair of large paraesophageal hiatus hernia: quality of life and durability. Parameswaran, R.; Ali, A.; Velmurugan, S.; Adjepong, S. E.; Sigurdsson, A. // Surgical Endoscopy;Aug2006, Vol. 20 Issue 8, p1221 

    Background: Laparoscopic repair of large paraesophageal hiatus hernias (LPOHH) is shown to be a safe and effective operation in the short term. However, its long-term durability and its effect on quality of life are less well established. This study aimed to assess the midterm...

  • Review of Literatures on Laparoscopic Prosthetic Repair of Giant Hiatal Hernia than Pure Anatomical Repair of Crura. Jeur, Amol S. // World Journal of Laparoscopic Surgery;May-Aug2010, Vol. 3 Issue 2, p85 

    The recurrence rate after laparoscopic primary repair of giant hiatal hernias with paraesophageal involvement is reported to be high. Mesh reinforcement repair of hiatal defect is proposed for solving this problem which is debated. The indication for mesh use, the type of mesh to use, and the...

  • Honor established writings. Bendavid, Robert // Hernia;Dec2003, Vol. 7 Issue 4, p165 

    The article provides information on the December 2003 issue of "Hernia." The researchers suggests that inguinal and femoral hernias should be viewed collectively as one entity. They state that the existence of conjoint tendon, lacunar ligament, fascia transversalis, iliopubic tract have never...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics