Key result
Lidocaine with triamcinolone acetonide reduced the incidence of pain at 3 months compared to lidocaine alone after inguinal hernioplasty (9.3% vs 22.7%; RR 0.48; 95% CI 0.23-0.97; p=0.026).
Why the study?
Inguinal hernioplasty can lead to chronic groin pain, prompting an evaluation of whether adding triamcinolone acetonide to lidocaine improves chronic pain management compared to lidocaine alone.
Does lidocaine with triamcinolone acetonide reduce postoperative pain in patients undergoing inguinal hernioplasty compared to lidocaine alone?
RCT (n=150)
randomized
No
Does lidocaine with triamcinolone acetonide reduce postoperative pain in patients undergoing inguinal hernioplasty compared to lidocaine alone?
The addition of triamcinolone acetonide to lidocaine significantly reduces the incidence of postoperative pain up to 3 months following inguinal hernioplasty.
Supports adding triamcinolone to lidocaine for inguinal hernioplasty; extends RCT evidence on steroid-local anesthetic adjuncts.
Background: Inguinal hernioplasty, also called Lichtenstein repair, is a common surgical procedure for inguinal hernia which can lead to chronic groin pain. Local anesthetic blocks combined with corticosteroids like lidocaine and triamcinolone have been used for post-operative pain management. This study aimed to compare the efficacy of lidocaine with triamcinolone acetonide versus lidocaine alone for chronic pain management in patients who underwent inguinal hernioplasty. Methods: A randomized control trial study was conducted at the Department of Surgery, Kulsoom Bai Valika Hospital, Karachi, Pakistan, from June 2022 to June 2023. The study included patients undergoing inguinal hernioplasty who were over 18 years of age. Group 1 (n=75) received a combination of lidocaine with triamcinolone acetonide, while group 2 (n=75) received lidocaine alone. Pain levels were assessed using the visual analog scale (VAS) during 1st week, 1st month, and 3rd month after the surgery. Results: In group 1, the incidence of pain in the 1st week was 25%, significantly lower than the 41.3% in group 2 (p=0.024). The risk ratio (RR) was 0.65 (95% CI=0.43-0.97, p=0.037). In the 1st month, group 1 had a 13.3% incidence of pain compared to 29.3% in group 2 (p=0.017), with an RR of 0.56 (95% CI=0.33-0.97). Similarly, in the 3rd month, group 1 had a 9.3% incidence of pain compared to 22.7% in group 2 (p=0.026), with an RR of 0.48 (95% CI=0.23-0.97). Conclusion: Lidocaine with triamcinolone acetonide is an effective approach for managing chronic postoperative pain in inguinal hernioplasty.
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A 2023 study conducted an RCT in chronic pain in postoperative inguinal hernioplasty (n=150). Lidocaine with triamcinolone acetonide vs. Lidocaine alone was evaluated on incidence of pain at 3 months (RR 0.48, 95% CI 0.23-0.97, p=0.026). Lidocaine with triamcinolone acetonide reduced the incidence of pain at 3 months compared to lidocaine alone after inguinal hernioplasty (9.3% vs 22.7%; RR 0.48; 95% CI 0.23-0.97; p=0.026).
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