A comparison between topical and infiltrative bupivacaine and intravenous meperidine for postoperative analgesia after inguinal herniorrhaphy

The purpose of the present study is to compare postoperative analgesia offe red by the simple instillation of local anesthetic on the surgical wound, i ts infiltration with the same local anesthetic, and the use of an intraveno us opioid. Sixty patients were divided into the three analgesia groups to b e studied: instillation of local anesthetic (Group I), injection of local a nesthetic (Group II), and intravenous opioid (Group III). The pain was quan tified using the visual analogue scale. It was observed that there was bett er analgesia in Groups I and II during the first 6 hours postoperatively as compared with Group III (P < 0.0001). At the end of the 12 hours the three modes of analgesia proved comparable. However, after 24 hours there was be tter analgesic development in Group I, whereas Group II had greater postope rative morbidity. We conclude that the instillation of local anesthesia pro vides analgesia during the immediate postoperative period comparable to loc al infiltration using the same anesthetic. Both regional analgesia methods are more effective analgesics during the first 6 hours than are intravenous opioids. Furthermore the simple instillation of local anesthetic allows be tter analgesic evolution of the surgical wound after the first 24 hours con sidering the lower rate of resulting complications.