Abstract

Background: Postoperative pain care is an essential component of the anesthesia armamentarium. Nerve blocks with local anesthetic drugs do an important role in that care. Many drugs have been added to prolong the duration of action of local anesthetics. We wished to add polygeline to look into the prolongation possibly because of its physical effects.

Aims and Objective: To evaluate the addition of polygeline to bupivacaine in ilioinguinal and iliohypogastric nerve blocks in patients undergoing hernioraphy.

Materials and Methods: Sixty patients undergoing hernioraphy under spinal anesthesia were randomly divided into three groups of 20 each. End operatively, they received saline (group C), bupivacaine with saline (group B), or bupivacaine with polygeline (hemaccel) (group BH) as the drug for ilioinguinal and iliohypogastric blocks. Postoperatively, 0–10 pain scores numerical rating scale (NRS), sedation scores, time to first analgesia, and narcotic requirements were noted. The narcotic was in the form of intravenous pentazocine (12 mg). Any side effects including 3-month follow-up for any neurological symptoms were noted. One way ANOVA with SPSS software, version 16.0 was used.

Result: The age, sex, and the duration of surgery were similar in all the three groups. The NRS and the sedation scores were significantly high in 0 h in group C than the other groups. Later, they were similar and comparable between groups. The narcotic requirement was significantly higher in group C than other groups. In a comparison between groups, the pentazocine requirement was higher in group B than group BH but was not statistically significant. The time to first analgesia was significantly higher in group BH, which was higher than group C. There were no undue side effects in any group. A 3-month follow-up did not report any neurological symptom in patients of any group.

Conclusion: Addition of polygeline to bupivacaine in nerve blocks provides early postoperative pain relief by possibly prolonging the duration of action of bupivacaine. Even though the narcotic requirements are less with addition of polygeline in the first postoperative 12 h, it is not statistically significant. There were no untoward side effects.

Key words: nerve blocks, local anesthetics, adjuvant, polygeline