scholarly journals Current options in local anesthesia for groin hernia repairs

2011 ◽  
Vol 58 (3) ◽  
pp. 25-35 ◽  
Author(s):  
Hakan Kulacoglu ◽  
Alp Alptekin
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Local Anesthesia ◽  
Regional Anesthesia ◽  
Local Anaesthesia ◽  
Groin Hernia ◽  
Local Anaesthetics ◽  
Health Care Economics ◽  
Groin Hernia Repair ◽  
Solid Foods

Inguinal hernia repair is one of the most common procedures in general surgery. All anesthetic methods can be used in inguinal hernia repairs. Local anesthesia for groin hernia repair had been introduced at the very beginning of the last century, and gained popularity following the success reports from the Shouldice Hospital, and the Lichtenstein Hernia Institute. Today, local anesthesia is routinely used in specialized hernia clinics, whereas its use is still not a common practice in general hospitals, in spite of its proven advantages and recommendations by current hernia repair guidelines. In this review, the technical options for local anaesthesia in groin hernia repairs, commonly used local anaesthetics and their doses, potential complications related to the technique are evaluated. A comparison of local, general and regional anesthesia methods is also presented. Local anaesthesia technique has a short learning curve requiring simple training. It is easy to learn and apply, and its use is in open anterior repairs a nice way for health care economics. Local anesthesia has been shown to have certain advantages over general and regional anesthesia in inguinal hernia repairs. It is more economic and requires a shorter time in the operating room and shorter stay in the institution. It causes less postoperative pain, requires less analgesic consumption; avoids nausea, vomiting, and urinary retention. Patients can mobilize and take oral liquids and solid foods much earlier. Most importantly, local anesthesia is the most suitable type of anesthesia in elder, fragile patients and patients with ASA II-IV scores.

scholarly journals Mortality and Urological Complications After Open Groin Hernia Repair in Local, General, and Regional Anesthesia: A Nationwide Linked Register Study

2019 ◽  
pp. 145749691987758
Author(s):  
J. H. H. Olsen ◽  
K. Andresen ◽  
S. Öberg ◽  
L. Q. Mortensen ◽  
J. Rosenberg
Keyword(s):  
Confidence Interval ◽  
Hernia Repair ◽  
General Anesthesia ◽  
Urinary Retention ◽  
Local Anesthesia ◽  
Regional Anesthesia ◽  
Odds Ratio ◽  
Groin Hernia ◽  
Groin Hernia Repair ◽  
Urological Complications

Background and Aims: The choice of anesthesia method may influence mortality and postoperative urological complications after open groin hernia repair. We aimed to investigate the association between type of anesthesia and incidence of urinary retention, urethral stricture, prostate surgery, and 1-year mortality after open groin hernia repair. Materials and Methods: Data were linked from the Danish Hernia Database, the national patient register, and the register of causes of death. We investigated data on male adult patients receiving open groin hernia repair from 1999 to 2013 with either local anesthesia, regional anesthesia, or general anesthesia. In relation to the type of anesthesia, we compared mortality and urological complications up to 1 year postoperatively. We adjusted for covariates in a logistic regression assessing urological complications and with the Cox regression assessing mortality. Results: We included 113,069 open groin hernia repairs in local anesthesia, regional anesthesia, or general anesthesia. The risk of urinary retention adjusted for covariates was higher after both general anesthesia (adjusted odds ratio = 1.64, 95% confidence interval = 1.05–2.57, p = 0.031) and regional anesthesia (odds ratio = 2.99, 95% confidence interval = 1.67–5.34, p < 0.0005) compared with local anesthesia. The adjusted risk of prostate surgery was also higher for both general anesthesia (odds ratio = 1.58, 95% confidence interval = 1.23–2.03, p < 0.0005) and regional anesthesia (odds ratio = 1.90, 95% confidence interval = 1.40–2.58, p < 0.0005) compared with local anesthesia. Type of anesthesia did not influence 1-year mortality or the risk for urethral stricture. Conclusion: Patients undergoing open groin hernia repair in local anesthesia experience the lowest rate of urological complications and have equally low mortality compared with patients undergoing repair in general anesthesia or regional anesthesia.

Laparoscopic repair of inguinal hernia: Prospective evaluation at a tertiary care center

2020 ◽  
Vol 23 (2) ◽  
pp. 54-58
Author(s):  
ABM Mahbubur Rahman ◽  
Tamjeed Alam ◽  
AHM Shamsul Alam ◽  
Fahim Ferdaus ◽  
Gazi Gias Uddin
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Groin Hernia ◽  
Tertiary Care ◽  
Groin Hernia Repair ◽  
Groin Hernias ◽  
Laparoscopic Groin Hernia Repair ◽  
Repair Techniques

Background: Treatment of groin hernias continues to evolve. The emergence of laparoscopic inguinal hernia surgery has challenged the conventional gold standard Lichtenstein’s tension free mesh repair. Laparoscopic technique to achieve surgical correction over groin hernia is increasingly being practiced in our country, and it is imperative to test the overall outcome of this technique in a tertiary care setting. Objectives: Current study was aimed at evaluating the per-operative events, early and late outcomes of laparoscopic groin hernia repair techniques. End points of evaluation were postoperative pain, hospital stay, resumption of normal activities, chronic pain and recurrence. Methods: Within a 2-year period, 45 patients of groin hernias of different clinical types underwent laparoscopic inguinal hernia repair in Bangladesh Medical College Hospital were recruited in this prospective observational study. Preoperative findings, intraoperative course, postoperative and follow-up data were analyzed to evaluate the outcomes. Observations were made regarding operating time, operative hazards, postoperative pain, incidence of early post-operative morbidities, hospital stay, resumption of activities. Total 24 months follow-up was carried out with regards to normal activity, late complications notably chronic groin pain and recurrence. Results: The mean age of 38.1±11.1 years, 27(60%) patients underwent TEP repair whereas, TAPP procedure was carried out in 18 patients (40%). For unilateral hernia repair using TEP technique, mean operative time was 50.3±4.2 mints and 61.7±5.3 mints for direct and indirect variety (D/I), with the corresponding rates for TAPP repair being 65.0±2.2 mints and 72.8±3.2 mints (D/I) respectively. Conversion rate to other operative procedure was 6.67%. The overall surgery related early post-operative morbidity was 7.4% (TEP) and 16.8% (TAPP). 3 out of 45 patients (6.67%) experienced chronic pain in the groin in the study. However, there was no single incidence of recurrence observed during the follow up period. Conclusion: Laparoscopic groin hernia repair techniques are safe and feasible, offers the benefits of minimally invasive surgery and becoming the procedure of choice specially for bilateral and recurrent inguinal hernias. Journal of Surgical Sciences (2019) Vol. 23(2): 54-58

scholarly journals TP9.2.13Outcomes of Emergency Groin hernia repair: 30-months experience of a tertiary care hospital

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Dileep Kumar ◽  
Brandon Tan ◽  
Michael Guilbert ◽  
Mohamed Elsllabi ◽  
Girivasan Muthukumarasamy
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Femoral Hernia ◽  
Mesh Repair ◽  
Groin Hernia ◽  
Bowel Resection ◽  
Wound Complications ◽  
Suture Repair ◽  
Mesh Infection ◽  
Groin Hernia Repair

Abstract Aims Repair of Emergency groin hernia is variable across different regions and even within same units. Mesh is increasingly used these days. We aim to evaluate peri-operative and long-term outcomes over last 30-months. Methods Retrospective analysis of all emergency groin hernia repairs from January 2018- July 2020 in a tertiary Centre. Case notes and electronic patient records (clinical portal, PACS system etc.) used for data collection. Results Of 89 emergency groin hernia repairs 62(69.7%) males, 32/89 (35.9%) indirect inguinal hernia and 29 (32.5%) femoral hernia. Median age 72 years (range 20-95), 74(83.1%) primary hernia and 15(16.9%) recurrent hernias. Femoral hernia was most common in females 25/27 (92.5%) in contrast 58/62 males (93.5%) had inguinal hernia. All patients, except 1(1.1%) laparoscopic, had open repair, 11/89 cases (12.3%) required bowel resection, of those 10 (90.9%) had suture repair. Additionally, 6/89 cases (6.7%) needed laparotomy. Of 68/89 (76.4%) cases who had mesh repair, 52(76.4%) were inguinal and 23.5% (16/68) femoral hernia. Only 55% femoral hernias repaired with mesh. Median LOS was 3 days (range 0-54), 6/89 cases (6.74%) had wound complications (3 wound infections, 2 haematoma and 1 fluid collection). With median 19 months (range 6-36 months) follow-up, 1(1.1%) recurrence each in both mesh and suture repair groups, no mesh infection and 2/89 (2.2%) 30-day mortality recorded. Conclusion Mesh repair is increasingly used in emergency groin hernia repair without increased risk of mesh infection, although suture repair is still preferred in groin hernias requiring bowel resection.

scholarly journals COMPARISON OF LOCAL VERSUS SPINAL ANAESTHESIA IN INGUINAL HERNIA REPAIR

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Dharmpal Godara ◽  
Mamta Choudhary
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Spinal Anesthesia ◽  
Local Anesthesia ◽  
Spinal Anaesthesia ◽  
Local Anaesthesia ◽  
Day Case ◽  
Randomized Clinical Study ◽  
Case Surgery ◽  
Group B

Background: To determine whether local anaesthetic technique is an acceptable alternative to spinal anaesthesia for hernia repair, especially with regards to operative conditions, postoperative pain relief and complications. Methods: This was a prospective randomized clinical study consisting of 100 patients. The patients posted for tension free lichtenstein elective hernioplasty were allocated to either of two groups, group A (n=50) were given local anaesthesia and patients in group B (n=50) were given spinal anaesthesia. Results: There was no demographic difference between the two groups. Time taken in local anesthesia was higher than spinal anesthesia. Intraoperative pain was higher in local anesthesia than spinal anesthesia. Conclusions: We concluded that local anaesthesia can be a preferred method in day-case hernia surgeries owing to its advantages of ease of administration and less complications. Keywords: Day-case surgery, Inguinal hernia, Local anaesthesia, Spinal anaesthesia

scholarly journals Comparison of local versus spinal anaesthesia in inguinal hernia repair

2020 ◽  
Vol 7 (12) ◽  
pp. 4107
Author(s):  
Suraj Bhardwaj ◽  
Shuchi Sharma ◽  
Vatika Bhardwaj ◽  
Roshan Lal
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Spinal Anesthesia ◽  
Inguinal Hernia Repair ◽  
Local Anesthesia ◽  
Spinal Anaesthesia ◽  
Local Anaesthesia ◽  
Day Case ◽  
Duration Of Surgery

Background: Inguinal hernioplasty remain one of the most commonly performed operations worldwide.  Local anaesthesia can be a preferred method in day-case hernia surgeries. Present study was thus conducted to determine whether local anaesthetic technique is an acceptable alternative to spinal anaesthesia for hernia repair, especially with regards to operative conditions, postoperative pain relief and complications.Methods: This was a prospective randomized single blinded clinical study consisting of sixty patients conducted after the ethical committee clearance. The patients posted for tension free lichtenstein elective hernioplasty were allocated to either of two groups, group A (n=30) were given local anaesthesia and patients in group B (n=30) were given spinal anaesthesia. The operative and postoperative pain sore using visual analogue scale, duration of surgery and any other complications were recorded.Results: There was no demographic difference between the two groups. Time taken in local anesthesia was higher than spinal anesthesia. Intraoperative pain was higher in local anesthesia than spinal anesthesia. There was no difference in post-operative pain scores (p>0.05). Post-operative complications were more in spinal anesthesia group e.g. urinary retention, headache, etc.Conclusions: Local anesthesia can be another good choice for inguinal hernia repair owing to its advantages and less complications, but it can’t be confirmed that local anaesthesia is better than spinal anaesthesia. It can be reliably concluded that local anaesthesia can be a preferred method in day-case hernia surgeries owing to its advantages of ease of administration and less complications.

Outcome of tension free open mesh repair of inguinal hernia

2020 ◽  
Vol 22 (1) ◽  
pp. 21-24
Author(s):  
Mohammad Masum ◽  
Md Aminul Islam ◽  
Masflque Ahmed Bhuiyan ◽  
Kazi Mazharul Lslam ◽  
Md Selim Morshed ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Mesh Repair ◽  
Groin Hernia ◽  
Synthetic Mesh ◽  
Indirect Inguinal Hernia ◽  
Prolene Mesh ◽  
Tension Free ◽  
Open Mesh Repair

Background: In the practice of General Surgery, hernia repair is the second most common procedure after appendectomy. Several methods have been developed over the years to try to improve hernia repair. Good result can be expected using Bassini's, McVay's, Shouldice's techniques provided the exact nature of hernia is recognized and the repair is done without tension using healthy tissue. The introduction of synthetic mesh started a new era in hernia surgery. The use of synthetic mesh repair of primary and recurrent hernias has gradually gained acceptance among surgeons. Objective: To find out the outcome and complications of open inguinal hernia repair with prolene mesh. Methods: This is a prospective cross sectional study conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from December, 2011 to May, 2012. One hundred patients of inguinal hernia admitted in different surgical units of BSMMU, Dhaka for elective surgery were studied. We have given 1 gm ijv Cephradine per operatively and then 500 gm cephradine ijv 6 hourly for 24 hours followed by oral form of Cephradine for next 5 days. Polypropylene mesh of 11 cm x 7 cm size was used in all cases. All the operations were done by open tension free prolene mesh repair technique. Patients were followed for one year to see the outcome. Results: Out of 100 cases of inguinal hernia, 71 patients (71%) had indirect inguinal hernia and 29 cases (29%) had direct inguinal hernia; 90 cases (90%) were primary hernia and only 10 cases (10%) were recurrent hernia; 58 cases were right sided, 34 cases (34%) were left sided and 8 cases (8%) were bilateral. Complications of mesh repair of groin hernia in this study included wound infection (5%), scrotal oedema (2%), mesh infection (0%), scrotal hematoma (2%), echymoces of peri-incisional skin (5%), early wound and groin pain (7%), chronic inguinodynia (2%), hernia recurrence (1%). Conclusion: In the present study an attempt is made to evaluate the outcome of patients undergoing inguinal hernia repair by prolene mesh. The results confirm that Lichtenstein tension free mesh repair of inguinal hernia is safe and reliable for both primary and recurrent groin hernia, with less recurrence rate. Patient's compliance was good with minimum morbidity. Journal of Surgical Sciences (2018) Vol. 22 (1): 21-24

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