Local anesthetic added to spinal anesthesia; does it stabilize stress hormones after inguinal herniorrhaphy?: A randomised controlled trial

Abstract

BackgroundElective inguinal hernia repair is a common minor surgery. Early postoperative mobilization without inflammatory related complication is desired. MethodsIn this randomized controlled trial study 48 adult males were enrolled who experienced elective inguinal hernia repair under spinal anesthesia. Subjects were categorized in 2 groups with equal 24 members in each including patients received local anesthetic (2 mg kg−1 of bupivacaine 0.5%) in addition to spinal anesthesia and controlled who had spinal anesthetic with local placebo injection. Plasma cortisol and prolactin concentration were obtained 1 h before and 3 h after operation. To evaluate severity of postoperative pain the visual analogue scale(VAS) was applied. We also measured the total dosage of analgesic requirement among patients. ResultsData showed that spinal anesthesia alone was followed by increasing plasma concentration of either cortisol or prolactin postoperatively (P < 0.01). Findings according to investigate severity of pain implied on that local anesthesia could make more postoperative comfort for patients with inguinal herniorrhaphy(P < 0.001). Therefore, analgesic requirement in patients who were equipped by additional local anesthesia also decreased(P < 0.001). ConclusionsWe concluded that adding local anesthetic to basic spinal anesthesia during inguinal herniorrhaphy could induce to either lower stress hormones plasma concentration or decrease pain and need for analgesic postoperatively.