International Surgery Journal | May 2023 | Vol 10 | Issue 5 Page 847 International Surgery Journal Ozer M et al. Int Surg J. 2023 May;10(5):847-851 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Original Research Article Effect of spraying bupivacaine and dexamethasone on postoperative pain of total extraperitoneal hernioplasty: a retrospective analysis Mehmet Özer*, Serap Ulusoy, İbrahim Kılınç, Mustafa Oruç INTRODUCTION Inguinal hernia surgeries are at the top of operations performed by general surgeons worldwide. 1,2 Postoperative pain management is also important for surgical patients. Laparoscopic total extraperitoneal (TEP) herniorrhaphy is a widely accepted technique for repairing inguinal hernias, and it has the advantage of reducing postoperative pain compared with open repair. 3,4 On the first day after surgery, pain is usually felt in the abdominal wall rather than in the incision sites, as the dissection is performed in the abdominal wall. Local anesthetics, such as lidocaine and bupivacaine, are commonly used as regional anesthesia in most surgical procedures. Local anesthetics increase postoperative analgesia and patient satisfaction when used with a multimodal approach. Even though many studies have been conducted on the use of preperitoneal local anesthetic instillation following TEP laparoscopic hernioplasty, the results remain inconsistent. By applying dexamethasone to the preperitoneal area, inflammation, and therefore pain, may also decrease. Combined infiltration of bupivacaine and dexamethasone ABSTRACT Background: Several studies on the reduction of pain with the use of local anesthetics after laparoscopic hernia surgeries have been published. We aimed to analyze the results of local anesthesia applied to the patients by retrospectively scanning the files of patients who underwent total extraperitoneal laparoscopic hernioplasty for inguinal hernias. Methods: The files of patients who underwent TEP laparoscopic hernioplasty for inguinal hernias between March 2019 and November 2022 in Ankara Bilkent city hospital general surgery clinic were retrospectively scanned. The pain scoring records in the observation forms of these patients and the analgesics administered were recorded. Results: A total of 374 and 210 patients underwent unilateral and bilateral TEP laparoscopic hernioplasty, respectively. All of the patients, 232 were not administered any local anesthesia, 186 were administered bupivacaine, and 166 were administered bupivacaine+dexamethasone. When the VAS scores of the patients in both main groups were compared, significant differences were found in VAS scores between patients who received bupivacaine and bupivacaine+dexamethasone and those who did not (p<0.036 and p<0.025). No difference was found between patients who received only bupivacaine and those who were given bupivacaine+dexamethasone. Conclusion: In patients who underwent TEP laparoscopic hernioplasty, spraying bupivacaine into the preperitoneal area after surgery was found to be significantly effective in reducing postoperative pain. The benefits of adding dexamethasone to bupivacaine have not been established. Keywords: TEP laparoscopic hernioplasty, Postoperative pain, Local anesthesia, Bupivacaine, Dexamethasone Department of General Surgery, Bilkent City Hospital, Ankara, Turkey Received: 18 March 2023 Revised: 13 April 2023 Accepted: 19 April 2023 *Correspondence: Dr. Mehmet Özer, E-mail: dr.mehmet.ozer@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: https://dx.doi.org/10.18203/2349-2902.isj20231379