[Preoperative or postoperative local anesthesia. Effect on postoperative pain treatment]

A randomized, double-blind trial was conducted to compare the efficacy of preincisional and postincisional wound infiltration with 1% lidocaine (40 ml) on postoperative pain. Thirty-seven patients scheduled for elective inguinal herniotomy participated. The demand for additional postoperative analgesics occurred earlier in those who received lidocaine infiltration after incision (165 min) than in those who received preincisional lidocaine (225 min), p < 0.05). The preincisional lidocaine infiltration group also had fewer patients requiring supplemental analgesics (58%) than the postincisional group (94%) (p < 0.05). We conclude that preincisional infiltration of the surgical wound with lidocaine is a more effective method for postoperative analgesia than postincisional infiltration.