A Comparison between Topical and Infiltrative Bupivacaine and Intravenous Meperidine for Postoperative Analgesia after Inguinal Herniorrhaphy

Waechter, Fabio Luiz; Sampaio, Jose Artur; Pinto, Rinaldo Danesi; Alvares-Da-Silva, Mario Reis; Pereira-Lima, Luiz
May 2001
American Surgeon;May2001, Vol. 67 Issue 5, p447
Academic Journal
The purpose of the present study is to compare postoperative analgesia offered by the simple instillation of local anesthetic on the surgical wound, its infiltration with the same local anesthetic, and the use of an intravenous opioid. Sixty patients were divided into the three analgesia groups to be studied: instillation of local anesthetic (Group I), injection of local anesthetic (Group II), and intravenous opioid (Group III). The pain was quantified using the visual analogue scale. It was observed that there was better analgesia in Groups I and II during the first 6 hours postoperatively as compared with Group III (P < 0.0001). At the end of the 12 hours the three modes of analgesia proved comparable. However, after 24 hours there was better analgesic development in Group I, whereas Group II had greater postoperative morbidity. We conclude that the instillation of local anesthesia provides analgesia during the immediate postoperative period comparable to local infiltration using the same anesthetic. Both regional analgesia methods are more effective analgesics during the first 6 hours than are intravenous opioids. Furthermore the simple instillation of local anesthetic allows better analgesic evolution of the surgical wound after the first 24 hours considering the lower rate of resulting complications.


Related Articles

  • The Effect of Subcutaneous Dexamethasone Added to Bupivacaine on Postcesarean Pain: A Randomized Controlled Trial. Jabalameli, Mitra; Saryazdi, Hamid; Massahipour, Omolbanin // Iranian Journal of Medical Sciences;Mar2010, Vol. 35 Issue 1, p21 

    Background: Previous studies have shown a prolonged blockade of nerves using bupivacaine-dexamethasone microspheres. The goal of this study was to assess the effect of subcutaneous dexamethasone added to bupivacaine on post cesarean pain. Methods: After randomization, 75 healthy parturients were...

  • Preemptive Analgesia: Decreasing Pain Before It Starts. Siwek, Jay // American Family Physician;5/15/2001, Vol. 63 Issue 10, p1924 

    Editorial. Presents an overview of an article on the use of preemptive analgesia for treating pain after surgery. Mechanisms involved in the treatment; Effectiveness of the treatment.

  • Information from your family doctor. Pain Relief After Surgery.  // American Family Physician;5/15/2001, Vol. 63 Issue 10, p1985 

    Presents information on the administration of pain relief after surgery. Information on pain management; Approaches in the administration of pain medicines; Information on preemptive analgesia.

  • Thoracic paravertebral block after thoracotomy: comparison of three different approaches Garutti, Ignacio; González-Aragoneses, Federico; Biencinto, Maria Teresa; Novoa, Emma; Simón, Carlos; Moreno, Nicolás; Cruz, Patricia; Benito, Carmen // European Journal of Cardio-Thoracic Surgery;May2009, Vol. 35 Issue 5, p829 

    Abstract: Background: Thoracic paravertebral block (TPVB) is a regional block technique increasingly used for the early management of post-thoracotomy pain. We compare three different postoperative analgesic approaches based on TPVB: anesthetist, anesthetist plus surgeon, and surgeon. Materials...

  • El dolor agudo perioperatorio y el paracetamol: una visión basada en la evidencia. Covarrubias-Gómez, Alfredo; González-García, José Luis; Betancourt-Sandoval, José A.; Mendoza-Reyes, Jonathan J. // Revista Mexicana de Anestesiologia;ene-mar2013, Vol. 36 Issue 1, p47 

    Settings: Surgical procedures in Mexico are frequent. It is possible that during the next five years the number procedures will increase a 20%. It has been reported that 80% of surgical patients will present pain and 80% of those in pain will report a moderate to severe intensity. National and...

  • Accidental epidural injection of rocuronium. Shin, Sang-Wook; Yoon, Ji-Uk; Baik, Seong-Wan; Lee, Hyeon-Jung; Ri, Hyun-Su // Journal of Anesthesia;2011, Vol. 25 Issue 5, p753 

    Epidural administration of local anesthetics or opioid during general anesthesia is a widespread method for postoperative analgesia. Despite the availability of this technique, inadvertent administration of nonepidural medications into the epidural space can be associated with serious...

  • Local anaesthetic wound infiltration in addition to standard anaesthetic regimen in total hip and knee replacement: long-term cost-effectiveness analyses alongside the APEX randomised controlled trials. Marques, Elsa M. R.; Blom, Ashley W.; Lenguerrand, Erik; Wylde, Vikki; Noble, Sian M. // BMC Medicine;Jul2015, Vol. 13 Issue 1, p1 

    Background: The Arthroplasty Pain Experience (APEX) studies are two randomised controlled trials in primary total hip (THR) and total knee replacement (TKR) at a large UK orthopaedics centre. APEX investigated the effect of local anaesthetic wound infiltration (LAI), administered before wound...

  • Liposome bupivacaine reduces postoperative pain, opioid burden.  // Reactions Weekly;10/20/2012, Issue 1424, p2 

    The article discusses several studies which examined the effectiveness of bupivacaine liposome injectable suspension in reducing postoperative opioid burden and pain.

  • Patient-Controlled Analgesia for Postoperative Pain. Ebell, Mark H. // American Family Physician;12/1/2007, Vol. 76 Issue 11, p1645 

    The article focuses on the effectiveness of patient-controlled opioid analgesia compared with a conventional analgesia for post operative pain. It states that patient-controlled opioid analgesia is safe and provides improvement in analgesia in postoperative patients. It notes that...


Read the Article


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

Try another library?
Sign out of this library

Other Topics