The novel use of different bupivacaine preparations with combined regional techniques for postoperative pain management in non-opioid-based laparoscopic inguinal herniorrhaphy

J Clin Anesth. 2016 Nov:34:403-6. doi: 10.1016/j.jclinane.2016.05.011. Epub 2016 Jun 8.

Abstract

Opioids are important for surgical pain control but may not be appropriate for patients with narcotic abuse histories or opioid intolerance. We describe a laparoscopic bilateral inguinal herniorrhaphy performed without perioperative or postoperative narcotics. Postoperative analgesia involves a novel technique using 2 different bupivacaine formulations that act synergistically to avoid lag time and provide extended pain relief during the acute surgical recovery phase.

Keywords: Hernia, inguinal; Herniorrhaphy; Laparoscopy; Narcotics; Nerve block; Pain, postoperative.

Publication types

  • Case Reports

MeSH terms

  • Analgesics, Non-Narcotic / administration & dosage
  • Analgesics, Non-Narcotic / therapeutic use
  • Anesthesia, General / methods
  • Anesthesia, Local / methods*
  • Anesthesia, Spinal
  • Anesthetics, Local / administration & dosage
  • Anesthetics, Local / therapeutic use
  • Atracurium / administration & dosage
  • Atracurium / analogs & derivatives
  • Bupivacaine / administration & dosage*
  • Bupivacaine / therapeutic use*
  • Drug Synergism
  • Hernia, Inguinal / surgery
  • Herniorrhaphy / methods*
  • Humans
  • Laparoscopy
  • Liposomes
  • Male
  • Middle Aged
  • Neuromuscular Blockade / methods
  • Pain Management / methods*
  • Pain Measurement / methods
  • Pain, Postoperative / drug therapy*

Substances

  • Analgesics, Non-Narcotic
  • Anesthetics, Local
  • Liposomes
  • Atracurium
  • cisatracurium
  • Bupivacaine