Combined subfascial and subcutaneous bupivacaine instillation for inguinal hernia wounds.

Autor:	El-Radaideh KM; Division of Anaesthesiology, Department of Surgery and Anaesthesiology, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan. elradk01@yahoo.com, Al-Ghazo MA, Bani-Hani KE
Jazyk:	angličtina
Zdroj:	Asian journal of surgery [Asian J Surg] 2006 Oct; Vol. 29 (4), pp. 242-6.
DOI:	10.1016/S1015-9584(09)60096-8
Abstrakt:	Objective: To determine if combined subfascial (SF) and subcutaneous (SC) bupivacaine is more effective than SC bupivacaine only in decreasing postoperative pain and opioid requirement for hernia wounds. Methods: Sixty consecutive male patients undergoing inguinal hernia repair were randomly allocated to one of two groups. Patients in the SC group (S; n = 30) received SC instillation of 10 mL of 0.25% bupivacaine and SF instillation of 10 mL of 0.9% saline, while patients in the combination group (C; n = 30) received SF and SC instillation of 10 mL of 0.25% bupivacaine each. All injections were given in a standardized manner by the surgeon during wound closure. Postoperative pain was scored by means of a 100 mm visual analogue scale. Results: Pain scores at 1, 12 and 24 hours postoperatively were significantly more in group S patients (53 vs. 30, 41 vs. 32 and 22 vs. 15, respectively, p < 0.0001). First time to analgesia was longer in group C (260 +/- 17 vs. 137 +/- 12 minutes, p < 0.0001). The consumption of pethidine was significantly lower in group C than in group S (23 +/- 34 mg vs. 55 +/- 42 mg, p = 0.003). Conclusion: SF combined with SC instillation of bupivacaine during wound closure prolongs the first time to analgesia, reduces early postoperative opioid requirements and lowers pain in males undergoing open hernia repair.
Databáze:	MEDLINE
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