• M E Ausems, K W Hulsewé, P M Hooymans, and A G Hoofwijk.
• Maasland Hospital, Orbis medisch en zorgconcern, Post-box 5500, 6130 MB Sittard, The Netherlands. m.ausems@orbisconcern.nl
• Anaesthesia. 2007 Apr 1;62(4):325-31.

AbstractThe aim of this study was to evaluate our postoperative pain protocol after ambulatory herniorrhaphy and to determine how infiltration with local anaesthetics would add to our management of postoperative pain. Two groups of 60 patients, scheduled for herniorrhaphy, received wound infiltration with 20 ml levobupivacaine 0.5% or saline 0.9%. Postoperatively, the patients regulated their own analgesic consumption and registered VAS scores, use of analgesics and side-effects in a diary for 5 days. The median time to first analgesic, the pain visual analogue scale scores, number of patients using no analgesic and the use of analgesic medication were significantly lower in the levobupivacaine group in the first 24 h, but not thereafter. Most patients used acetaminophen in the first 5 days after surgery and occasionally diclofenac. Only a minority used tramadol. Our multimodal pain protocol achieved reasonable results at rest, but a considerable number of patients experienced moderate to severe pain with movement.

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