# Effect of Bupivacaine-Soaked Polypropylene Mesh on Postoperative Pain in Patients Undergoing Lichtenstein Repair for Inguinal Hernia

## TL;DR

This study shows that using bupivacaine-soaked mesh during hernia surgery reduces postoperative pain and shortens hospital stays.

## Contribution

Demonstrates that bupivacaine-soaked mesh significantly reduces pain and hospitalization after hernia repair.

## Key findings

- Bupivacaine-soaked mesh reduced pain scores at 6, 12, and 24 hours post-surgery.
- Patients with bupivacaine-soaked mesh required less diclofenac and were discharged faster.
- 67.4% of bupivacaine group were discharged by day 3 versus 4.7% in the control group.

## Abstract

Background: Inguinal hernia repair is among the most common general surgical procedures worldwide, with the Lichtenstein tension-free mesh repair regarded as the gold standard due to its low recurrence rates and favorable outcomes. However, postoperative pain remains a significant concern. The use of bupivacaine-soaked mesh has been proposed as a technique to enhance analgesia and facilitate faster recovery.

Objectives: This study aimed to evaluate the efficacy of 0.5% bupivacaine-soaked polypropylene mesh in reducing postoperative pain and hospital stay in patients undergoing Lichtenstein repair for unilateral inguinal hernia.

Methods: A prospective cohort study was conducted over 18 months in a tertiary care teaching hospital in Northern India, involving 86 adult patients undergoing elective unilateral inguinal hernia repair. Participants were divided into Group A (bupivacaine-soaked mesh) and Group B (non-soaked mesh). Pain was assessed using the Visual Analogue Scale (VAS) at six, 12, and 24 hours postoperatively. Additional analgesic requirements and hospital stay duration were also recorded. Statistical analysis was performed using IBM SPSS Statistics for Windows, version 24.0 (IBM Corp., Armonk, New York, United States).

Results: Both groups were comparable in baseline characteristics. Group A showed significantly lower VAS scores at six hours (3.95 ± 0.53 vs 4.53 ± 0.68), 12 hours (3.56 ± 0.50 vs 4.09 ± 0.8), and 24 hours (1.65 ± 0.48 vs 2.32 ± 0.52) (p < 0.05). Diclofenac requirement was significantly lower in Group A (p = 0.0004), and 67.4% were discharged by day 3 compared to 4.7% in Group B (p < 0.0001).

Conclusion: The use of 0.5% bupivacaine-soaked mesh in Lichtenstein repair significantly reduces postoperative pain and shortens hospital stay, supporting its role as an effective adjunct in inguinal hernia surgery.