SUBCUTANEOUSLY VERSUS SUBFASCIALLY ADMINISTERED LIDOCAINE IN PAIN TREATMENT AFTER INGUINAL HERNIOTOMY

We conducted a randomized, prospective, double-blind trial to compare the efficacy of subfascial (SF) versus subcutaneous (SC) lidocaine (10 mL 1%) given in the wound postoperatively through a catheter placed i n the respective layer intraoperatively. The initial pain scores were similar in the two groups before injection of lidocaine. In the SC gro up, there was a reduction in pain scores during rest from 4 to 3 (P > 0.05), during cough from 6 to 5 (P > 0.05), and during mobilization fr om 7 to 5.5 (P > 0.05) at 15 min. In the SF group, the reductions in p ain scores were from 4 to 2 (P < 0.05), from 6 to 3 (P < 0.05), and fr om 7 to 3 (P < 0.05), respectively. Supplemental analgesics after the lidocaine administration were needed earlier in the SC group than in t he SF group (P < 0.01). We conclude that postoperative pain treatment with local lidocaine application after herniotomy has a better effect when applied in the SF, rather than the SC, layer.