Prospective double-blind randomised study of a new regimen of pre-emptive analgesia for inguinal hernia repair: Evaluation of postoperative pain course

Objective: To evaluate the effectiveness of a new regimen of pre-emptive an algesia on the development of postoperative pain after inguinal hernia repa ir. Design: Prospective, double-blind, randomised study. Setting: University Hospital, Germany. Subjects: 70 consecutive patients who had primary unilateral inguinal herni a repairs. Interventions: A new regimen of pre-emptive analgesia with bupivacaine that was infiltrated preoperatively, intraoperatively, and postoperatively was tested. The control group were given saline infiltrations at the same times . Pain was measured up to postoperative day 30 using the visual analogue sc ale (VAS), the verbal rating scale (VRS), and by recording patient-controll ed use of ibuprofen suppositories. Results: Pain was significantly less in the pre-emptive analgesia group tha n in the control group during the first 10 days postoperatively as assessed by VAS and VRS (p < 0.05). Analgesic consumption was also significantly re duced in the preemptive analgesia group (p < 0.05). Multivariate analysis s howed that bupivacaine infiltration (pre-emptive analgesia) was associated with significantly less postoperative pain (p < 0.0001). Conclusion: This regimen of pre-emptive analgesia is an effective and safe method of reducing postoperative pain and analgesic consumption after ingui nal hernia repair.