Does tramadol or bupivacaine intraincisional infiltration with inguinal canal block during hernioplasty change the postoperative pain profile?

Abstract

Objective The study aimed to evaluate the effect of inguinal canal block together with intraincisional injection of tramadol against bupivacaine 0.25% on both intraoperative and postoperative pain relief in patients undergoing inguinal hernioplasty under general anesthesia. Patients and methods The study was conducted on 60 male patients scheduled for elective inguinal hernioplasty under general anesthesia in the Kasr Al-Ainy School of Medicine. Patients were randomly allocated into three groups: group C [control group (n = 20)], group B [bupivacaine 0.25% group (n = 20)], and group T [tramadol group (n = 20)]. During the surgery, the mean arterial blood pressure and the heart rate were traced every 5 min. The total intraoperative fentanyl requirement, postoperative visual analogue score and sedation scores, and nausea and vomiting were recorded; patient and surgeon satisfaction were assessed. Results The intraoperative mean arterial blood pressure, heart rate, and fentanyl requirement were statistically lower in both the bupivacaine and the tramadol groups compared with the control group. The postoperative visual analogue score was statistically lower in both the bupivacaine and the tramadol groups compared with the control group. Postoperative nausea and vomiting were statistically higher in the tramadol group compared with the control group and the bupivacaine groups. The scoring of postoperative patient satisfaction was statistically higher in the tramadol group compared with the bupivacaine and the control groups. Conclusion The study offered a new technique using tramadol as a locally infiltrated drug during inguinal hernioplasty aiming to decrease intraoperative and postoperative pain together with reducing analgesic needs to minimum during and after the operation with the consequent beneficial reduction of narcotic side effects.