A Randomized Control Trial of Levobupivacaine, Bupivacaine Versus Placebo Extraperitoneal Infusion in Totally Extraperitoneal Laparoscopic Inguinal Hernioplasty

Background. Totally extraperitoneal (TEP) laparoscopic inguinal hernioplasty procedure is significantly less painful than open repair, but it is not completely painless. The aim of this study was to compare the effect of extraperitoneal infusion of 0.25% levobupivacaine, 0.25% bupivacaine, and placebo in patients undergoing TEP procedure in terms of pain reduction. Methods. Twenty patients were included in each group for TEP procedure. Group A received 40 mL of 0.9% normal saline, group B received 40 mL of 0.25% bupivacaine, and group C received 40 mL of 0.25% levobupivacaine infused into the extraperitoneal space before closing. Postoperative pain was assessed at 4, 8, 12, 24, 36, and 48 h postoperatively. Analgesic requirement, complications, and overall satisfaction were also recorded. Results. The demographic and surgical characteristics of the patients did not significantly differ among groups. There were no statistical differences among groups in postoperative pain scores, total IV-PCA morphine requirement, complications, and overall satisfaction. Conclusion. Extraperitoneal infusion 40 mL of 0.25% bupivacaine or 0.25% levobupivacaine following TEP procedure did not show any benefit over placebo in terms of pain reduction. (C) 2010 Elsevier Inc. All rights reserved.