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Invited Commentary
September 21, 2016

Improved Recovery After Laparoscopic Bilateral Inguinal Hernia RepairPerception vs Function Improvement?

Author Affiliations
  • 1University of Texas Southwestern Medical Center, Dallas
JAMA Surg. Published online September 21, 2016. doi:10.1001/jamasurg.2016.2906

Sakamoto and colleagues1 present a randomized, prospective, single-blinded study examining early recovery after bilateral laparoscopic inguinal hernia repair. One treatment group had a transversus abdominis block (TAP) performed by the anesthesiologist, while another group had preperitoneal installation of local anesthetic (PILA) and dexamethasone by the surgeon. A control group had no local intervention. Pain scores blinded to treatment arm, postoperative opioid use, and results of a Quality of Recovery–40 Questionnaire (QoR-40)2 on the first postoperative day were analyzed. The TAP decreased opioid use in the postanesthesia care unit, but not thereafter, and did not significantly improve global QoR-40 score. Although PILA did not decrease opioid use, global QoR-40 scores were significantly better than for either control or TAP patients.1

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