Key result
Local anesthesia with bupivacaine significantly reduced postoperative plasma cortisol (P=0.001), prolactin (P=0.013), and pain scores up to 72 hours (P<0.0001) compared to placebo.
Why the study?
Does local anesthesia with bupivacaine reduce stress hormone release and postoperative pain in adult male patients undergoing inguinal hernia repair?
RCT (n=48)
Does local anesthesia with bupivacaine reduce stress hormone release and postoperative pain in adult male patients undergoing inguinal hernia repair?
p-value: p=0.001 and 0.013
Local anesthesia with bupivacaine significantly reduces postoperative pain, analgesic consumption, and stress hormone release in patients undergoing inguinal hernia repair.
Supports routine local bupivacaine use in inguinal hernia repair; extends RCT evidence for regional techniques in attenuating surgical stress.
Background: postoperative pain is a most prevalence complication in herniorrhaphy whatever the management of this pain is a basic problem. The aim of this study was to compare the effects of pre and post incisional infiltration of the surgical area with bupivacaine on cortisol and prolactin release and postoperative pain in patients undergoing inguinal hernia repair.Methods: In this clinical trial study, 48 adult male patients have undergone inguinal hernia repair and spinal anesthesia, assigned to 2 groups. Local anesthesia was performed by 2 mg/kg bupivacaine 0.5% while placebo group did not receive any local anesthesia. Plasma cortisol and prolactin were compared in both groups.Results: In postoperatively, the plasma concentration of cortisol and prolactin in local anesthesia group were significantly lower than placebo group (P = 0.001 and P = 0.013, respectively). Visual Analog Scale (VAS) in local anesthesia group was significantly lower than placebo group in 12, 24, 48 and 72 hrs after operation (P < 0.0001, for all four). Also, there was a significant correlation between the two groups according to rescues analgesic (P < 0.0001).Conclusions: The finding of the current study suggests that usage of local anesthesia is a safe, effective and feasible procedure as decreases the cortisol and prolactin hormones, postoperative pain and analgesic drugs consumption.
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Kolahdouzan et al. (2018) conducted an RCT in Inguinal hernia (n=48). Local anesthesia with bupivacaine vs. Placebo was evaluated on Plasma concentration of cortisol and prolactin (p=0.001 and 0.013). Local anesthesia with bupivacaine significantly reduced postoperative plasma cortisol (P=0.001), prolactin (P=0.013), and pain scores up to 72 hours (P<0.0001) compared to placebo.
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