Abstract
BackgroundInguinal hernia is one of the most common diseases in the elderly. Treatment of this pathology is exclusively surgical and relies almost always on the use of local anesthesia. While in the past hernia surgery was carried out mainly by general anesthesia, in recent years there has been growing emphasis on the role of local anesthesia.MethodsThe aim of our study was to compare intra-and postoperative analgesia obtained by the use of levobupivacaine to the same obtained by bupivacaine. Bupivacaine is one of the main local anesthetics used in the intervention of inguinal hernioplasty. Levobupivacaine is an enantiomer of racemic bupivacaine with less cardiotoxicity and neurotoxicity. The study was conducted from March 2011 to March 2013. We collected data of eighty patients, male and female, aged between 65 and 86 years, who underwent inguinal hernioplasty with local anesthesia.ResultsEvaluation of intra-operatively pain shows that minimal pain is the same in both groups. Mild pain was more frequent in the group who used levobupivacaine. Moderate pain was slightly more frequent in the group who used bupivacaine. Only one reported intense pain. Two drugs seem to have the same effect at a distance of six, twelve, eighteen and twentyfour hours. Bupivacaine shows a significantly higher number of complications, as already demonstrated by previous studies. Degree of satisfaction expressed by patients has been the same in the two groups. Levobupivacaine group has shown a greater request for paracetamol while patients who experienced bupivacaine have showed a higher request of other analgesics.ConclusionsClinical efficacy of levobupivacaine and racemic bupivacaine are actually similar, when used under local intervention of inguinal hernioplasty. In the field of ambulatorial surgery our working group prefers levobupivacaine for its fewer side effects and for its easy handling.
Highlights
Inguinal hernia is one of the most common diseases in the elderly
Inguinal hernia is one of the most common diseases in elderly. Treatment of this type of pathology is exclusively surgical and relies almost always on the contribution of local anesthesia. This type of anesthesia has significantly improved the treatment of inguinal hernia, significantly reducing recurrences, complications, recovery time and return to normal working activities
Do not forget that we are talking about local assisted anesthesia and the contribution of the anesthetist, and the overall effectiveness of the anesthesia, are essential to ensure the maximum comfort to the patient intraoperatively [5]
Summary
Inguinal hernia is one of the most common diseases in the elderly Treatment of this pathology is exclusively surgical and relies almost always on the use of local anesthesia. Inguinal hernia is one of the most common diseases in elderly Treatment of this type of pathology is exclusively surgical and relies almost always on the contribution of local anesthesia. Do not forget that we are talking about local assisted anesthesia and the contribution of the anesthetist, and the overall effectiveness of the anesthesia, are essential to ensure the maximum comfort to the patient intraoperatively [5] This type of anaesthesia consists of several phases: the first, percutaneous, may be made without distinction by the surgeon or anesthesiologist, while the last phase, incisional, is exclusively of surgical pertinence, as it is the task of the surgeon to identify the points of landmarks, locate and infiltrate properly. Purpose of our study has been to compare clinical efficacy of two anesthetics, levobupivacaine and bupivacaine, commonly used during surgical treatment of inguinal hernia [23,24,25]
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