Early-Term Pain Management After Laparoscopic Total Extraperitoneal Inguinal Hernia Repair

Abstract

Introduction: The aim of the present study was to determine if the use of local anesthesia by different ways would reduce postoperative pain after laparoscopic total extraperitoneal inguinal hernia repair.Methods: Thirty patients were randomly divided into three groups. Upon completion of the prolene mesh repair, Group 1 (mean age: 45.8±8.6 years) received 5 cc levobupivacaine installed into the preperitoneal space every 6 h for 24 h via a catheter placed to the preperitoneal space. In Group 2 (mean age: 44.9±11.5 years), levobupivacaine-soaked spongostan was placed into the preperitoneal space after the placement of the prolene mesh. Group 3 (mean age: 45.4±10.7 years) was determined as the control group and received 75 mg diclofenac sodium after inguinal hernia repair. Pain was assessed by using a Visual Analog Scale of 1 (minimal pain) to 10 (worst pain) at fixed time intervals of 0, 6, 12, 18, and 24 h after surgery.Results: The trend of postoperative pain in 0, 6, and 18 h of Group 1 was significantly lower than that of Group 3 (p<0.001). There was no significant difference between Group 1 and Group 3 in terms of postoperative 12 (p=0.012) and 24 (p=0.037) hour pain levels. The trend of postoperative pain in 0, 6, 12, 18, and 24 h of Group 2 was lower than that of the other two groups (p<0.001).Conclusion: Placement of bupivacaine-soaked spongostan into the preperitoneal space resulted in least postoperative pain between the three groups. The application of placement of bupivacaine-soaked spongostan is a safe and effective method.

Keywords

• Inguinal hernia
• laparoscopic repair
• postoperative pain
• local anesthesia