AI Article Synopsis
- Inguinodynia, a painful complication after inguinal mesh surgery, affects 13-37% of patients, prompting a study on the effectiveness of bupivacaine infiltration to reduce immediate postoperative pain.
- A trial with 100 patients was conducted, comparing those who received only spinal anesthesia versus those who also received bupivacaine at targeted nerves; pain scores were measured at 3 and 6 hours post-surgery.
- Results showed the bupivacaine group experienced lower pain scores, but there was no significant difference in the occurrence of inguinodynia or the need for additional pain relief medications between the groups.
Article Abstract
Introduction: Inguinodynia after inguinal meshplasty is a notable complication with an incidence of 13-37%. We wanted to determine if a perineural infiltration of bupivacaine given intraoperatively would reduce the incidence of immediate postoperative pain and inguinodynia.
Methodology: We have conducted a single-blinded randomized controlled trial including 100 patients with inguinal hernia. Patients in the control group received only spinal anaesthesia. The intervention group received perineural bupivacaine infiltration in addition to spinal anaesthesia. Intraoperatively Ilioinguinal, iliohypogastric, and genital branch of the genitofemoral nerve was identified and 2 mL of 0.5% bupivacaine was given perineurally along these identified nerves. Presence of inguinodynia, immediate post-operative pain scores using the Wong-Baker faces pain scale, duration of analgesics use, use of additional analgesics along with Paracetamol 500 mg tablet, and the length of hospital stay between the groups were recorded.
Results: 100 patients were randomized in the study, 49 in control and 51 in the intervention group. Both the group was comparable in terms of demographic characteristics. The intervention group had significantly lower median pain score at 3 h [4 ± 1.662 vs. 6 ± 1.55; = .0001] and 6 h [4 ± 1.33 vs. 6 ± 1.307; = .0001]. The incidence of inguinodynia did not significantly differ between the two groups (-value = .12).
Conclusion: Intraoperative Perineural bupivacaine infiltration significantly reduces the immediate postoperative pain. However, there was no significant reduction in the incidence of inguinodynia or additional analgesic requirement.
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| http://dx.doi.org/10.1080/00015458.2020.1860401 | DOI Listing |
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