scholarly journals Comparison of Combined General-Epidural Anesthesia and General Anesthesia in Patients Undergoing Laparoscopic Inguinal Hernia Repair Operation

2016 ◽  
Vol 06 (04) ◽  
pp. 164-168
Author(s):  
潺 李
Author(s):  
Nashwa Atef Badawy ◽  
Mona Blough El Mourad ◽  
Ahmed Said AL Gebaly ◽  
Yasser Mohamed Amr

Background: Inguinal hernia repair is one of the most common surgical procedures in the pediatric age group and it is associated with significant post-operative discomfort. The aim of this study is to compare the safety, reliability, and efficacy of ultrasound-guided transverses abdominis plane (TAP) block versus erector spinae plane (ESP) block for postoperative pain control in pediatrics undergoing laparoscopic inguinal hernia repair. Methods: This prospective randomized study was carried out on 90 pediatric patients of both sexes aged (2 -7) years with ASA physical status I/II scheduled for elective laparoscopic inguinal hernia repair. Patients were divided into 3 equal groups. Group C received general anesthesia alone. group T received bilateral ultrasound-guided TAP block after induction of general anesthesia with the injection of 0.4 ml/kg bupivacaine 0.25%. group E received bilateral ultrasound-guided ESP block after induction of general anesthesia with the injection of 0.4 ml/kg bupivacaine 0.25%. Results: According to CHEOPS, we found no statistically significant difference between ESP and TAP groups but significant increase in the control group. also, There was a significant decrease in total rescue analgesia (intra-operative & postoperative ) in the T group and E as compared to group C. Also there was a significant delay in onset of first rescue analgesia post operatively between group T&E in comparison to group C. The mean value of heart rate between the 3 groups showed no statistically significant difference between TAP and ESP groups intra-operatively but significant increase in heart rate in the control group in all stages of the operation as compared to T& E groups. Mean arterial blood pressure changes were insignificant between three groups in all stages of operation. Conclusions: TAP block and ESP block are effective and safe techniques for postoperative pain control in pediatric patients undergoing laparoscopic inguinal hernia repair with more hemodynamic stability, less intra and postoperative analgesia requirement.


2020 ◽  
Vol 24 (5) ◽  
Author(s):  
Carla Hipólito ◽  
Vicente Vieira ◽  
Virginia Antunes ◽  
Petra Alves ◽  
Adriana Rodrigues ◽  
...  

Background: Inguinal hernia is one of the most common conditions presented for surgical repair in children and laparoscopic approaches are increasingly performed. Previous studies have shown safety and efficacy in the use of supraglottic devices (SGD) as an alternative to tracheal intubation, which fits particularly well with outpatient anesthesia. Methodology: we conduct a retrospective observational study, collecting data from the electronic anesthetic form, from all patients aged 0 to 17 y who underwent ambulatory laparoscopic percutaneous internal ring suturing between February 2015 and August 2019, if I-gelTM was used to airway management. Results: We found 230 patients meeting the inclusion criteria. The mean age was 5.2 y old, mean weight 20.1 kg. All patients were ASA I (n=203) or ASA II (n=27). The mean surgery duration was 38 minutes. We found 4 respiratory adverse events, three bronchospasms, and one laryngospasm, managed in the operating room. Ninety percent of the surgeries were performed without neuromuscular blockade. Conclusion: I-gelTM was a safe, effective, and convenient alternative to airway management to laparoscopic inguinal hernia repair in the ambulatory setting. According to available literature, our practice did not represent an increased risk for the studied respiratory events. SGD obviates the need for neuromuscular blockade. Key words: I-gel; Supraglottic devices; Laparoscopy; Inguinal hernia repair; Pediatrics; Anesthesia, ambulatory Citation: Hipólito C, Vieira V, Antunes V, Alves P, Rodrigues A, Santos MJ. Airway management with I-gelTM for ambulatory laparoscopic inguinal hernia repair in children; a retrospective review of 230 cases. Anaesth. pain intensive care 2020;24(5): Received: 18 February 2020, Reviewed: 5 August, 6 September 2020, Accepted: 11 September 2020


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hazem AbdelSalam Mohamed ◽  
Karim Fahmy ◽  
Mohammad Ahmad Abd-erRazik ◽  
Shaimaa Atef Ismaeil Awwad Elkomy

Abstract Background The fundamental mechanism of abdominal wall hernia formation is the loss of structural integrity at the musculotendinous layer. The exact cause of inguinal hernia is still unknown but the factors contributing in its occurrence include; preformed congenital sac, chronic passive rise in the intra-abdominal pressure and weak abdominal wall. Aim of the Work To assess intra-operative difficulties of laparoscopic inguinal hernia repair using two different meshes: The conventional polyproline mesh and the three-dimensional (3D) mesh, as regard the operative time. And early post-operative complications including post-operative seroma, early postoperative pain, chronic pain and limitation of function. Patients and Methods In our study 30 patients were recruited according to our preset inclusion and exclusion criteria. They were divided randomly into two groups, a group in which the 3D mesh was used and a group in which the polypropylene mesh was used. The study was conducted in Ain Shams University hospitals for 6 months, in which patients where followed up from 3 to 6 months and compared in terms of intraoperative time, post-operative pain after one week, restriction of physical activity, seroma formation and presence of chronic pain. Results In our study the mean application time (minutes) in 3D group was found to be 7.07 ± 2.66 while in PP group it was found to be 12.53±3.66 with highly statistically significant difference between them at p < 0.001. We believe that this difference in fixation time in our present study is attributed to easy insertion through the port, easy intraoperative handling, and easy unfolding of 3D mesh. Conclusion The use of three-dimensional mesh (3D mesh) for laparoscopic inguinal hernia repair is a safe and viable option. It offers many advantages in terms of less fixation time, shorter hospital stays, early recovery with a better movement limitation score. Whereas chronic pain was found to be similar in both groups. Further, elimination of tacks for fixation and shorter hospital stay may reduce the cost of 3D mesh. Longer-term studies are recommended with a larger sample size and follow up duration for better assessment of chronic pain, also for following up on recurrence.


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