Analgesic Effects of Naproxen Suppository and Local Marcaine Injection on Inguinal Hernia Surgery

Abstract

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) are routinely used after surgery, especially after minor procedures such as inguinal herniorrhaphy. Local anesthetics such as marcaine are also used in many minor procedures. Objectives: The aim of this study was to examine the efficacy and safety of a commonly used NSAID, naproxen, versus wound infiltration by marcaine, on inguinal herniorrhaphy. We hypothesized that naproxen would reduce postoperative pain fallowing inguinal hernia repair surgery more effectively than local marcaine injection, but the possible complications may be the same or less. Patients and Methods: In this double-blind controlled clinical trial, 150 patients undergoing inguinal herniorrhaphy were divided into three groups: A (marcaine infiltration in the wound + sup-placebo), B (two sup-naproxen suppositories) and C (sup-placebo). Standard analgesic and antiemetic were available to all the patients. Primary endpoints were postoperative pain, measured at the beginning of the operation, 22 O'clock at night, and the tomorrow morning, using visual analogue scale (VAS) score and the dosage of morphine that the patients needed. Results: Baseline characteristics were equivalent between the three groups. In group B with naproxen, after the operation, decreased pain by 65 ± 23% at the beginning, decreased pain by 34 ± 16% at the 22 O'clock at night and decreased pain by 19 ± 12% at the tomorrow morning were observed. In this group, the patients received 4.4 ± 2 mg less morphine (A), versus the marcaine (B) and the placebo groups (P < 0.001). No side effects or complications were observed fallowing naproxen administration. Conclusions: Naproxen is an effective and low-cost adjunct for pain control after inguinal herniorrhaphy surgery. It is also better than wound infiltration with marcaine because of lower incidence of complications and morphine consumption.