scholarly journals Prophylaxis and treatment of acute and chronic postoperative inguinal pain (CPIP)—association of pain with compression neuropathy†

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
René Gordon Holzheimer ◽  
Nikolai Gaschütz
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Recurrence Rate ◽  
Nerve Damage ◽  
Preoperative Pain ◽  
Compression Neuropathy ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

Abstract Can open inguinal hernia repair (OIHR) and tailored neurectomy (TN) be effective for prophylaxis of chronic postoperative inguinal hernia repair (CPIP) (I) and treatment of CPIP (II)? Patients with symptomatic primary inguinal hernia (I group 1) and secondary hernia with CPIP (II, groups 2–5) were investigated for postoperative complications and nerve damage. About, 98% of patients with OIHR with TN reported preoperative pain (I group 1, n = 388, recurrence rate 1%). There were 73 cases (II) of CPIP after laparoscopic inguinal hernia repair (LIHR) (group 2, n = 22), OIHR (group 3, n = 37), LIHR followed by OIHR/LIHR (group 4, n = 5) and OIHR followed by LIHR/OIHR (group 5, n = 9). The results were as follows: preoperative pain: 33–100%, recurrence rate 0–11% (II, groups 2–5), nerve damage 92–100% and persistent CPIP: n = 1 after trocar perforation of inguinal nerve elsewhere. OIHR is effective to avoid CPIP with compression neuropathy. This is the largest series of histological nerve damage in CPIP.

Bupivacaine Hydrochloride and Ketamine Hydrochloride with Dextrose Given Intrathecally for Inguinal Hernia Repair - A Randomized Controlled Study in a Tertiary Centre in South Kerala

2021 ◽  
Vol 8 (31) ◽  
pp. 2830-2834
Author(s):  
Ranju Sebastian ◽  
Remani Kelan Kamalakshi ◽  
Jamsheena Muthira Parambath ◽  
Praseetha Vallomparambath Kuttiparambil
Keyword(s):  
Inguinal Hernia ◽  
Side Effects ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Spinal Anaesthesia ◽  
Controlled Study ◽  
Hyperbaric Bupivacaine ◽  
Haemodynamic Stability ◽  
Group 2 ◽  
Group 1

BACKGROUND Spinal Anaesthesia is the most commonly used form of anaesthesia for surgeries below the level of umbilicus. Bupivacaine is the drug of choice for subarachnoid block. Spinal anaesthesia with bupivacaine is associated with many side effects and complications especially in patients with multiple co-morbid conditions. In our study we compared the anaesthetic effectiveness of 3.5 ml hyperbaric bupivacaine with a mixture of 100 mg ketamine and 0.1 mg adrenaline, the solution is made hyperbaric by adding 1.4 ml of 5 % dextrose given intrathecally. The objective of our study was to compare the anaesthetic properties and clinical effectiveness of intrathecally administered ketamine with bupivacaine for inguinal hernia repair. METHODS This randomised control study was conducted on fifty American society of Anaesthesiologists (ASA) 1 and 2 patients in the age group of 25 – 60 years posted for elective inguinal hernia repair from December 2004 to December 2005. They were randomized in to two groups. Group 1 (Bupivacine group) and Group 2 (Ketamine group). Bupivacaine group (group 1) received 3.5 ml of bupivacaine heavy and ketamine group (group 2) received preservative free ketamine 100 mg with 0.1 mg adrenalin 1/1000 solution in 1.4 ml of 5 % dextrose to make it heavy. Anaesthetic properties, side effects and complications of both groups were compared intraoperatively. RESULTS The onset of action of ketamine (1.58 minutes) was faster than bupivacaine (3.31 minutes) which is statistically significant. Duration of blockade was longer in bupivacaine group (sensory 227.92 and motor 203.08) compared to ketamine group (sensory 143.40 and motor 109.46). Ketamine group showed a greater level of haemodynamic stability than bupivacaine group. CONCLUSIONS Intrathecal ketamine produces optimal anaesthetic conditions for surgeries like inguinal hernia repair. Haemodynamic stability provided by intrathecal ketamine is beneficial in patients with multiple comorbidities. KEYWORDS Hyperbaric Bupivacaine, Ketamine in Hyperbaric Solution, Intrathecal Block, Inguinal Hernia Repair

scholarly journals Is inguinal hernia repair safe for testicular atrophy? Our 10 year results

2021 ◽  
Vol 8 (2) ◽  
pp. 606
Author(s):  
Haydar Celasin ◽  
Faraj Afandiyev
Keyword(s):  
Inguinal Hernia ◽  
Rheumatic Disease ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Doppler Ultrasonography ◽  
Color Doppler ◽  
Testicular Atrophy ◽  
Inflammatory Drugs ◽  
Group 2 ◽  
Group 1

Background: We aimed to determine the incidence and predictors of testicular atrophy (TA) in patients undergoing inguinal hernia repair at our hospital.Methods: The total patient number is 578.The patients were divided Group-1 (developed testicular atrophy) and Group-2 (did not develop testicular atrophy). The testicles were evaluated with Scrotal Color Doppler Ultrasonography (SCDU) in preoperative and postoperative third month.Results: Median age in the Group - 1 and Group - 2 respectively is 64,0±12,3 (47-81) and 48,9±17,4 (18-89) (p=0.037). TA developed in 5.01% (29/578) of the patients. We determined that TA developed more often in the patients who are over the age of 40 (p=0.007), in secondary cases (p<0.001), in  open repair (p<0.001), those who do not use perioperative narcotic and Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) (p<0.001), those who use perioperative antispasmodic drugs (p=0.017), those having a rheumatic disease(RD) and  diabetes mellitus(DM) (p<0.001).Results of multivariate analysis, testicular atrophy development increases when perioperative NSAID is not used ( OR:13.24; 95% CI:4.19-41.87; p<0.001) , perioperative narcotic is not applied (OR:13.91; 95% CI:4.35-44.55; p<0.001) and RD exists (OR:0.10; 95%CI:0.03-0.35; p<0.001).Conclusions: Advanced age, DM and rheumatic disease, not using perioperative NSAIDs, narcotic drugs and antispasmodic drugs increases the risk of testicular atrophy.

scholarly journals Totally extraperitoneal inguinal hernia repair versus Lichtenstein repair: a one-year follow-up study

2021 ◽  
Author(s):  
H. O. Havrylov ◽  
O. V. Shulyarenko
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Lightweight Mesh ◽  
Lichtenstein Repair ◽  
Totally Extraperitoneal ◽  
Totally Extraperitoneal Hernia Repair ◽  
Group 2 ◽  
One Year ◽  
Group 1

The inguinal hernia has an incidence of 27 — 43 % in males. Surgical repair is the most accepted treatment to prevent the development of complications. Laparoscopic inguinal hernia repair has become popular worldwide and includes the use of a laparoscopic technique for mesh placement behind the defect. Objective — to assess whether totally extraperitoneal (TEP) inguinal hernia repair shows benefits over Lichtenstein repair in intraoperative and one‑year follow‑up postoperative outcomes for male patients with primary unilateral inguinal hernia. Materials and methods. 53 males were randomly allocated to two groups. Group 1 included 27 patients who underwent totally extraperitoneal hernia repair using self‑gripping lightweight mesh, and group 2 included 26 patients who were treated surgically with Lichtenstein repair using lightweight mesh. Results. Both groups were comparable in mean age, type of hernia, body mass index and patient’s distribution according to the European hernia society classification. TEP repair takes on average a little less time as compared to Lichtenstein repair, and this difference is not statistically significant. The mean of visual analogue scale for pain scoring in the first 24 hours after surgery as well as in the next 24 hours is statistically significantly smaller in group 1 compared to group 2. The mean time taken to return to work was 2.15 times longer in group 2 than in group 1, and the difference was statistically significant. Conclusions. Totally extraperitoneal hernia repair shows potential benefits over Lichtenstein repair for primary unilateral inguinal hernias as it causes less pain in the postoperative period and ensures early return to work.  

Inguinal Hernia Repair Using Self-adhering Sutureless Mesh: Adhesix™: A 3-Year Follow-up with Low Chronic Pain and Recurrence Rate

2016 ◽  
Vol 82 (2) ◽  
pp. 112-116 ◽  
Author(s):  
Malek Tabbara ◽  
Laurent Genser ◽  
Manuela Bossi ◽  
Maxime Barat ◽  
Claude Polliand ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Postoperative Complications ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Recurrence Rate ◽  
Initial Surgery ◽  
Complications Rate

To review our experience and outcomes after inguinal hernia repair using the lightweight self-adhering sutureless mesh “Adhesix™” and demonstrate the safety and efficacy of this mesh. This is a 3-year retrospective study that included 143 consecutive patients who underwent 149 inguinal hernia repairs at our department of surgery. All hernias were repaired using a modified Lichtenstein technique. Preoperative, perioperative, and postoperative data were prospectively collected. Incidence of chronic pain, postoperative complications, recurrence, and patient satisfaction were assessed three years postoperatively by conducting a telephone survey. We had 143 patients with a mean age of 58 years (17–84), who underwent 149 hernia repairs using the Adhesix™ mesh. Ninety-two per cent (131 patients) were males. Only 10 patients (7%) had a postoperative pain for more than three years. In our series, neither age nor gender was predictive of postoperative pain. Only one patient had a hematoma lasting for more than one month and only four patients (2.8%) had a recurrence of their hernia within three years of their initial surgery. Ninety per cent of the patient expressed their satisfaction when surveyed three years after their surgery. In conclusion, the use of the self-adhering sutureless mesh for inguinal hernia repair has been proving itself as effective as the traditional mesh. Adhesix™ is associated with low chronic pain rate, recurrence rate, and postoperative complications rate, and can be safely adopted as the sole technique for inguinal hernia repair.

Effects of training and supervision on recurrence rate after inguinal hernia repair

2004 ◽  
Vol 91 (6) ◽  
pp. 774-777 ◽  
Author(s):  
A. J. Robson ◽  
C. G. Wallace ◽  
A. K. Sharma ◽  
S. J. Nixon ◽  
S. Paterson-Brown
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Recurrence Rate ◽  
Training And Supervision

Low Recurrence Rate After Laparoscopic (TEP) and Open (Lichtenstein) Inguinal Hernia Repair

2009 ◽  
Vol 250 (2) ◽  
pp. 355
Author(s):  
Arne Eklund ◽  
Leif Bergkvist ◽  
Claes Rudberg ◽  
Agneta Montgomery ◽  
Ib Rasmussen ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Recurrence Rate ◽  
Laparoscopic Tep

scholarly journals Chronic Pain after Inguinal Hernia Repair

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Mallikarjuna Manangi ◽  
Santhosh Shivashankar ◽  
Abhishek Vijayakumar
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Nerve Injury ◽  
Statistical Significance ◽  
Preemptive Analgesia ◽  
Preoperative Pain ◽  
Hernia Surgery

Background. Chronic postherniorrhaphy groin pain is defined as pain lasting >6 months after surgery, which is one of the most important complications occurring after inguinal hernia repair, which occurs with greater frequency than previously thought. Material and Methods. Patients undergoing elective inguinal hernioplasty in Victoria Hospital from November 2011 to May 2013 were included in the study. A total of 227 patients met the inclusion criteria and were available for followup at end of six months. Detailed preoperative, intraoperative, and postoperative details of cases were recorded according to proforma. The postoperative pain and pain at days two and seven and at end of six months were recorded on a VAS scale. Results. Chronic pain at six-month followup was present in 89 patients constituting 39.4% of all patients undergoing hernia repair. It was seen that 26.9% without preoperative pain developed chronic pain whereas 76.7% of patients with preoperative pain developed chronic pain. Preemptive analgesia failed to show statistical significance in development of chronic pain (P=0.079). Nerve injury was present in 22 of cases; it was found that nerve injury significantly affected development of chronic pain (P=0.001). On multivariate analysis, it was found that development of chronic pain following hernia surgery was dependent upon factors like preoperative pain, type of anesthesia, nerve injury, postoperative local infiltration, postoperative complication, and most importantly the early postoperative pain. Conclusions. In the present study, we found that chronic pain following inguinal hernia repair causes significant morbidity to patients and should not be ignored. Preemptive analgesia and operation under local anesthesia significantly affect pain. Intraoperative identification and preservation of all inguinal nerves are very important. Early diagnosis and management of chronic pain can remove suffering of the patient.

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