A comparison of bupivacaine lavage and diclofenac suppository effects on post-operative pain of laparascopic transabdomi
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RESEARCH NOTE
A comparison of bupivacaine lavage and diclofenac suppository effects on post‑operative pain of laparascopic transabdominal pre‑peritoneal herniorrhaphy: a randomized clinical trial study Alireza Negahi1, Seyed Hamzeh Mousavi1, Vahid Abbasnezhad1 and Fatemeh Jahanshahi2*
Abstract Objectives: Injection of a topical anaesthetic has been proved to be helpful with reducing pain after laparoscopic herniorrhaphy. We aimed to assess the effect of bupivacaine lavage on postoperative pain and compare it with diclofenac suppository. In this randomized clinical trial, 60 patients—scheduled for laparoscopic herniorrhaphy—were enrolled and randomized into three groups of 20 each, including diclofenac suppository, bupivacaine lavage, and normal saline as a placebo.The patients were investigated for postoperative pain scores, vomiting, nausea, morphine request, and duration of hospitalization. Results: In the bupivacaine group, pain levels in recovery room, 4, 8 and 12 h after surgery, were significantly lower than diclofenac group; at time points of 16, 20 and 24 h after surgery, difference between two groups was not significant. Regarding vomiting and nausea, at time points of 1 and 3 h after surgery, results show no significant difference between the groups. Incident of infection, 1 h and 1 week after the surgery, was not significantly different among the groups. Duration of hospitalization in the bupivacaine group was much lower than the diclofenac group. Based on our results, use of the bupivacaine lavage can reduce postoperative pain in patients undergoing laparoscopic herniorrhaphy. Trial Registration Randomized clinical trial IRCT20180522039782N2; date of registration:14/10/2018 Keywords: Bupivacaine lavage, Diclofenac suppository, Postoperative pain, laparascopic, Herniorrhaphy, İnguinal hernia Introduction In recent years, repair of inguinal hernia with less invasive modern surgical techniques has minimized the possibility of relapse, and pared its acute postoperative pain, and improved patients’ satisfaction as well. However, *Correspondence: [email protected] 2 Student Research Committee, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran Full list of author information is available at the end of the article
despite the consistent advances, controlling postoperative chronic pain in this kind of surgery is still a challenge. Additional beneficial effects of less invasive surgical methods, such as laparoscopy, include a reduction in hospitalization costs, enhancing patients’ quality of life, raising the standard of health care and faster re-engagement of the patients in daily activities [1]. However, the research to date has failed to resolve the issue of controlling postoperative pain and still no precise management
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