Bicarbonate buffered local anaesthetic solutions are known to reduce the
pain of infiltration. However, its efficacy in reducing the
pain of infiltration in patients undergoing
inguinal hernia repair has never been tested. This study aims to test the efficacy of
bicarbonate buffered
solution in reducing the
pain of infiltration and
pain for the total
surgical procedure in a series of patients undergoing elective
inguinal hernia repair. Forty consecutive male patients with unilateral, reducible
inguinal hernias were studied prospectively. All patients underwent surgery under local anaesthesia, the first 20 with unbuffered
solution and the next 20 using buffered
solution.
Pain scores were obtained for the infiltration in the anaesthetic room and for the total
surgical procedure. In addition, satisfaction scores were obtained at the end of the procedure. The mean
pain score for the initial infiltration of unbuffered anaesthetic was 3.00 (range 0-5), and for the buffered anaesthetic it was 1.45 (range 0-4), P=0.02. The mean
pain score for the entire procedure for the unbuffered group was 3.05 (range 0-6), and for the buffered group it was 1.45 (range 0-5), P=0.02. The patient satisfaction rate was higher with the buffered
solution compared to unbuffered
solution (P<0.05). There were no complications reported with either
solution. Buffered local anaesthetic
solution significantly reduces the perceived
pain of
inguinal hernia repair, both during the infiltration and during the procedure itself. It is safe to administer and it results in a high rate of patient satisfaction.