EFFECT OF ILIOINGUINAL AND ILIOHYPOGASTRIC NERVE BLOCK AND WOUND INFILTRATION WITH 0.5-PERCENT BUPIVACAINE ON POSTOPERATIVE PAIN AFTER HERNIA REPAIR

We have compared, in 40 adult males, the effect on pain in the first 2 4 h after herniorrhaphy of preincisional ilioinguinal and iliohypogast ric nerve block and wound infiltration with 0.5% bupivacaine or saline . After operation, patients received morphine i.v. via a patient-contr olled analgesia machine and visual analogue pain scores (VAS) at rest and on movement were recorded. The bupivacaine group consumed less mor phine in the first 6 h after operation. There was no difference in mor phine consumption between the two groups in the next 18 h. The time to first analgesia was delayed in the bupivacaine group and was not foll owed by a rebound increase in requirement for analgesia. There was no significant difference in VAS scores at rest but there was a significa ntly higher pain score with movement in the saline group. We have show n that the combination of nerve block and wound infiltration reduces c onsumption of morphine in the first 24 h after herniorrhaphy. We have failed to show any effect of 0.5% bupivacaine beyond the first 6h afte r operation.