Which medications in the drug class Local Anesthetic/NSAID Combination are used in the treatment of Open Inguinal Hernia Repair?

Updated: May 21, 2021
  • Author: Vinay Kumar Kapoor, MBBS, MS, FRCS, FAMS; Chief Editor: Kurt E Roberts, MD  more...
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Local Anesthetic/NSAID Combination

Newer locally active analgesic modalities provide nonopioid options for postoperative pain management. The combination of bupivacaine and meloxicam was approved by the FDA in May 2021. Approval was based on the EPOCH-2 phase 3 trial. Among 418 patients undergoing unilateral open inguinal herniorrhaphy, bupivacaine/meloxicam demonstrated superior, sustained pain reduction through 72 hours, significantly reduced opioid consumption, and resulted in significantly more opioid-free subjects compared with saline placebo and bupivacaine. [60]

Bupivacaine/meloxicam (Zynrelef)

Indicated as a single dose that provides postsurgical analgesia for up to 72 hours after open inguinal herniorrhaphy. Apply solution without a needle into the surgical site after final irrigation and suctioning and before the suturing of each layer (when multiple tissue layers are involved). The solution is instilled above and below the fascial repair. 

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