Comparison of Analgesic effects of Marcaine subcutaneous and subfascial administration on inguinal hernia surgery

Monitoring of post-operative pain is one of the most important problems for patient and surgeon. Using a method with minimal pain and disability is desirable for both sides. This study aimed to compare analgesic effects of subcutaneous and subfascial administration of Marcaine in inguinal hernia surgery. In a double blind randomized controlled trial 128 cases of unilateral direct and indirect inguinal hernia were enrolled. Random allocation into two equal groups was done and demographic characteristics were collected. 10ml of Marcaine 0.5% was injected subfascially in the first group while the second received the same amount subcutaneously after repair of hernia. Severity of pain was assessed and compared after operation. Following two and four hours of Marcaine injection static and dynamic pain severity decreased in subfascial group significantly. These differences were persistent after adjusting for type of hernia. Static pain after four hours was decreasing in higher age groups. There was no relationship between pain and gender. The study showed that subfascial Marcaine injection was more effective to control pain after surgery in patients. We suggest more investigations with large sample size of direct and indirect inguinal hernias as well as other abdominal wall surgeries.