Department of Surgery at Manchester Royal Infirmary, and the University of Manchester, Manchester, UK.
Scand J Surg. 2010;99(1):18-23. doi: 10.1177/145749691009900105.
The potential analgesic benefit of infiltration of the wounds and extraperitoneal space with local anesthetic in patients undergoing laparoscopic totally extraperitoneal (TEP) repair of inguinal hernias remains unclear.
Consenting adults scheduled to undergo laparoscopic TEP repair of unilateral inguinal hernias were recruited to this randomized double-blind placebo-controlled clinical trial of 0.25% bupivacaine (Group I) versus saline (Group II) infiltration of abdominal wounds and the extraperitoneal space. Pain scores were assessed at 4 and 24 hours postoperatively using the short-form McGill pain questionnaire (SF-MPQ), the Present Pain Index (PPI) score and the visual analogue scale (VAS). The intravenous and oral analgesic requirements were recorded. Each patient completed questionnaire to assess their satisfaction with the postoperative analgesia.
40 patients were randomized (Group I, n = 20; Group II, n = 20). The two groups were comparable for age, gender, body mass index, and operating time. Minor complications occurred in one patient in each group. There were no significant differences in the postoperative SF-MPQ scores, PPI and VAS at 4 hours (p = 0.413, p = 0.631, p = 0.615 respectively) and 24 hours (p = 0.116, p = 0.310, p = 0.100 respectively) post-operatively. The parenteral and oral analgesics consumed post-surgery were comparable (p = 0.605, p = 0.235). No difference was ob-served in the patient satisfaction scores.
Infiltration of abdominal wounds and extraperitoneal space with bupivacaine in patients undergoing laparoscopic TEP repair of unilateral inguinal hernias does not appear to offer analgesic benefits.Key words: Laparoscopic; extraperitoneal; inguinal hernia; repair; pain; bupivacaine; analgesia; satisfaction; day case; randomized.
在接受腹腔镜完全腹膜外（TEP）疝修补术的患者中，局部麻醉浸润伤口和腹膜外间隙的潜在镇痛益处尚不清楚。
本随机双盲安慰剂对照临床试验纳入了 40 名计划接受单侧腹股沟疝腹腔镜 TEP 修补术的成年患者，他们被随机分为布比卡因（I 组）和生理盐水（II 组）组，分别接受腹部伤口和腹膜外间隙的浸润。术后 4 小时和 24 小时使用短格式麦吉尔疼痛问卷（SF-MPQ）、当前疼痛指数（PPI）评分和视觉模拟评分（VAS）评估疼痛评分。记录静脉和口服镇痛药物的需求。每位患者均完成问卷调查，以评估其对术后镇痛的满意度。
共纳入 40 例患者（I 组 n = 20，II 组 n = 20）。两组在年龄、性别、体重指数和手术时间方面具有可比性。每组各有 1 例患者发生轻微并发症。术后 4 小时（p = 0.413，p = 0.631，p = 0.615）和 24 小时（p = 0.116，p = 0.310，p = 0.100）SF-MPQ 评分、PPI 和 VAS 无显著差异。术后使用的静脉和口服镇痛药无差异（p = 0.605，p = 0.235）。患者满意度评分也无差异。
在接受腹腔镜 TEP 单侧腹股沟疝修补术的患者中，布比卡因浸润腹部伤口和腹膜外间隙似乎没有提供镇痛益处。
腹腔镜；腹膜外；腹股沟疝；修补术；疼痛；布比卡因；镇痛；满意度；日间手术；随机。
