Abstract
Herniorrhaphy and orchiopexy are increasingly performed on an outpatient basis in paediatric surgery. In such cases, postoperative analgesia should receive special attention so that the hospital stay need not be unnecessarily prolonged due to side effects of the analgesic agents, such as sedation, respiratory depression or vomiting. Therefore, the present study is a randomized double-blind investigation to assess the effectiveness of atraumatic intra-operative instillation of bupivacaine in the surgical site and the rectal application of acetaminophen as a postoperative analgesic following herniorrhaphy and orchiopexy. Male patients between the ages of 3 and 6 yr who were scheduled to receive ambulatory herniorrhaphy or orchiopexy were included in the study. One hundred children in each of the herniorrhaphy and orchiopexy groups were treated respectively with acetaminophen or with bupivacaine as the postoperative analgesic. Atraumatic intraoperative instillation of bupivacaine into the surgical site proved to be significantly superior as a postoperative analgesic in both the herniorrhaphy and orchiopexy groups as compared to rectal application of acetaminophen (χ 2 test: herniorrhaphy group P < 0.05; orchiopexy group P < 0.001). For herniorrhaphy and orchiopexy in childhood, local atraumatic instillation of bupivacaine during surgery into the wound bed is a simple, easy to use and reliable method for post-operative pain control with no side effects.
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