THE EFFECTS OF WOUND INFILTRATION WITH BUPIVACAINE VERSUS SALINE ON POSTOPERATIVE PAIN AND OPIOID REQUIREMENTS AFTER HERNIORRHAPHY

In a prospective, double-blind, placebo-controlled study, twenty-eight healthy, male patients, aged 20-69 years, scheduled for unilateral el ective inguinal herniorrhaphy ad modum Bassini were randomized to rece ive postoperative infiltration of the surgical wound with either bupiv acaine 0.25%, or isotonic saline. General anaesthesia was induced with thiopentone 3-5 mg.kg(-1) and alfentanyl 10 mu g.kg(-1), and maintain ed with alfentanyl 5 mu g.kg(-1) 15 min and N2O/O-2. After herniorrhap hy, the internal fascia was infiltrated with bupivacaine 0.25% or sali ne, 10 mi. After closure of the external fascia, the subcutaneous tiss ue was infiltrated with bupivacaine 0.25% or saline, 15 mi on both sid es of the surgical wound. Pain at rest, during mobilisation and during cough was significantly decreased in patients receiving bupivacaine c ompared to placebo. Median time to first request for morphine was incr eased from 25 min to 135 min, and the consumption of supplementary mor phine during the 24 h study period reduced from four to two doses of 0 .1 mg.kg(-1) iv or 0.125 mg.kg(-1) im, in patients who received bupiva caine compared to placebo.