Postoperative Analgesia in Inguinal Herniorrhaphy: Infiltration of 0.25% Bupivacaine before Incision VS before Repair of Incision

Postoperative pain is a bad experience which can cause many complications for patients. Nowadays many methods are used to eradicate or decrease pain and the most common methods are use of analgesics and other drugs. One of these methods is infiltrating local anesthetics in the surgical field. The aim of this study was to evaluate the effect of time of administration of analgesics(i.e before incision or before repair of incision) on post operative analgesia. Patients and Sixty patients undergoing herniorrhaphy were randomized to one of the three treatment groups. The patients were assigned randomly to three groups: Group A(preincisional): "pre" contained 10ml of 0.25% bupivacaine and "post" contained 10ml of 0.9% saline. Group B(postincisional): "pre" contained 10ml of 0.9% saline and "post" contained 10ml of 0.25% bupivacaine. Group C(control): both syringes contained 10ml of 0.9% saline. All patients underwent a general anesthesia induction and maintenance. After positioning and draping 10ml of the "pre" was infiltrated into the incision site after surgery and prior to closure of incision the "post" was infiltrated in the incision. The rate of pain and its scoring were significantly lower in the first group(preincisional) then two other groups(P<0.05). Hemodynamic variables had no significant difference in the three groups. In the first group, patients rate of pain at the first and second analgesic requests was significantly lower than the second group both being lower than control group. Also the mean dose of analgesia in the first 24 hours after the operation was lower in the first group then in the other two groups(P<0.05). The results show that postoperative analgesia gained by infiltration of local anesthetics in the surgical field before herniorrhaphy can reduce the rate of pain and the need for administering analgesics significantly.