ABSTRACT

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.

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.

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).

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