Quadratus Lumborum 2 Block as the Sole Anesthetic Technique for Open Hernia Repair in Multimorbid Patients

Given the rising rate of opioid-related adverse drug events during postsurgical pain management, a nonpharmacologic therapy that could decrease analgesic medication requirements would be of immense value. We designed a prospective, placebo-and-randomized controlled trial to assess the clinical effect of transcutaneous acupoint electrical stimulation (TEAS) on the postoperative patient-controlled analgesia (PCA) requirement for morphine, as well as side effects and recovery profile after inguinal hernia repair. Seventy-one subjects undergoing inguinal hernia repair with a standardized anesthetic technique were randomly assigned to one of three analgesic treatment regimens: PCA + TEAS (n = 24); PCA + sham-TEAS (no electrical stimulation) (n = 24), and PCA only (n = 23). The postoperative PCA requirement, pain scores, opioid-related side effects, and blood cortisol levels were recorded. TEAS treatment resulted in a twofold decrease in the analgesic requirement and decreased pain level reported by the patients. In addition, a significant reduction of cortisol level was reported in the TEAS group at 24 h postoperatively compared to the sham and control groups. We conclude that TEAS is a safe and effective option for reducing analgesic consumption and postoperative pain following inguinal hernia repair.

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Simple Purse String Laparoscopic Versus Open Hernia Repair

Journal of Laparoendoscopic & Advanced Surgical Techniques ◽

10.1089/lap.2014.0276 ◽

2016 ◽

Vol 26 (2) ◽

pp. 144-147 ◽

Cited By ~ 6

Author(s):

Mairi Steven ◽

Peter Carson ◽

Stephen Bell ◽

Rebecca Ward ◽

Merrill McHoney

Keyword(s):

Hernia Repair ◽

Purse String ◽

Open Hernia Repair

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Local or General Anesthesia for Open Hernia Repair: A Randomized Trial

Annals of Surgery ◽

10.1097/01.sla.0000059992.76731.64 ◽

2003 ◽

Vol 237 (4) ◽

pp. 574-579 ◽

Cited By ~ 63

Author(s):

Patrick J. O’Dwyer ◽

Michael G. Serpell ◽

Keith Millar ◽

Caron Paterson ◽

David Young ◽

...

Keyword(s):

Hernia Repair ◽

General Anesthesia ◽

Randomized Trial ◽

Open Hernia Repair

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Comparative study between laparoscopic trans-abdominal preperitoneal and open mesh hernioplasty in repair of non-complicated inguinal hernia

International Surgery Journal ◽

10.18203/2349-2902.isj20195944 ◽

2019 ◽

Vol 7 (1) ◽

pp. 24

Author(s):

Waleed Yusif El Sherpiny

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Hospital Stay ◽

Laparoscopic Hernia Repair ◽

Laparoscopic Group ◽

Routine Activities ◽

Group A ◽

Group B ◽

Open Hernia Repair ◽

Mesh Hernioplasty

Background: Inguinal mesh hernioplasty is one of the common procedures performed all over the world. It can be done either through open or laparoscopic techniques. The aim of this study was to compare the outcomes of Lichtenstein tension free hernioplasty versus laparoscopic transabdominal pre-peritoneal (TAPP) mesh repair considering, duration of the surgery, hospital stay, and duration to resume normal activity, degree of postoperative pain, wound infection, recurrence and complications.Methods: Adult patients presented to the general surgical OPD, with the diagnosis of inguinal hernia underwent either Lichtenstein repair or laparoscopic repair by TAPP.Results: Patients in Group A (open-repair) had significantly greater level of local pain during rest and during routine activities than those within Group B (laparoscopic group) during the postoperative period assessed on the visual-analogue scale. Mean operative time for open hernia repair was 43.7 minutes and for laparoscopic hernia repair was 59.03 minutes and the difference were statistically significant (p=0.0001). The mean duration of hospital stay for open hernia repair was 2.16 days and that for laparoscopic hernia repair was 1.08 days with a (p=0.00001) which was statistically significant. The time to resume routine activities was much shorter among Group B patients than patients in Group A. Only one recurrence (3.3%) was seen in Group B after 6 months follow up.Conclusions: It is concluded that laparoscopic TAPP repair of inguinal hernia in adults is safe and preferred operation as compared to open inguinal hernia repair.

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Ultrasound guided quadratus lumborum block for postoperative analgesia in pediatric ambulatory inguinal hernia repair

Journal of Clinical Anesthesia ◽

10.1016/j.jclinane.2018.02.002 ◽

2018 ◽

Vol 46 ◽

pp. 77-78 ◽

Cited By ~ 10

Author(s):

Can Aksu ◽

Yavuz Gürkan

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Postoperative Analgesia ◽

Ultrasound Guided ◽

Quadratus Lumborum Block ◽

Quadratus Lumborum

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Wound protectors for improved exposure in open hernia repair

Hernia ◽

10.1007/s10029-019-01952-6 ◽

2019 ◽

Vol 23 (6) ◽

pp. 1215-1219

Author(s):

J. Lawson ◽

A. McGill ◽

H. Meares ◽

H. Coleman ◽

C. Riveros ◽

...

Keyword(s):

Hernia Repair ◽

Open Hernia Repair

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Comparison of quadratus lumborum block and caudal block for postoperative analgesia in pediatric patients undergoing inguinal hernia repair and orchiopexy surgeries: a randomized controlled trial

Regional Anesthesia and Pain Medicine ◽

10.1136/rapm-2019-101027 ◽

2020 ◽

Vol 45 (3) ◽

pp. 187-191 ◽

Cited By ~ 4

Author(s):

Gözen Öksüz ◽

Mahmut Arslan ◽

Aykut Urfalıoğlu ◽

Ahmet Gökhan Güler ◽

Şeyma Tekşen ◽

...

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Postoperative Analgesia ◽

Pediatric Patients ◽

Demographic Data ◽

Parent Satisfaction ◽

Caudal Block ◽

Double Blind ◽

Quadratus Lumborum

Background and objectivesCaudal epidural anesthesia is a widely used popular technique for postoperative analgesia but it has potential side effects and duration of analgesia is short. Quadratus lumborum block (QLB) was found to be an effective method for postoperative analgesia in lower abdominal surgeries. In this double-blind prospective randomized trial, we aimed to compare the postoperative analgesic efficacies of QLB and the caudal block in pediatric patients undergoing inguinal hernia repair and orchiopexy surgeries under general anesthesia.Materials and methodsAfter approval was obtained from the ethics committee, in this prospective randomized double-blind trial, 53 patients under general anesthesia undergoing inguinal hernia repair and orchiopexy surgeries randomly received caudal block or QLB. Demographic data, postoperative analgesic requirement, Face, Legs, Activity, Cry, and Consolability (FLACC) scores at 30 min, 1, 2, 4, 6, 12 and 24 hours, parent satisfaction scores and complications were recorded.ResultsThe study included 52 patients, after excluding one patient because of a failed caudal block. There were no significant differences between the groups based on demographic data (p>0.05). The number of patients who required analgesics in the first 24 hours was significantly lower in QLB group (p=0.001). Postoperative 4, 6, 12 hours FLACC scores were significantly lower in the QLB group (p<0.001, p=0.001 and p<0.001, respectively). Parent satisfaction scores were higher in the QLB group (p=0.014).ConclusionAccording to the results of this study, QLB can provide much more effective analgesia than caudal block without adjuvants in multimodal analgesia management of children undergoing inguinal hernia repair and orchiopexy surgeries.Trial registration numberNCT03294291.

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Brief report: De Garengeot’s hernia

Case Studies in Surgery ◽

10.5430/css.v5n2p9 ◽

2019 ◽

Vol 5 (2) ◽

pp. 9

Author(s):

M. Hunter Witt ◽

Adam R. Eppler ◽

Ahmed M. Mahmoud

Keyword(s):

Hernia Repair ◽

Ct Scan ◽

Laparoscopic Appendectomy ◽

Amyand’S Hernia ◽

Femoral Canal ◽

Blunt Dissection ◽

Incarcerated Hernia ◽

De Garengeot’S Hernia ◽

Open Hernia Repair

We describe a case of a 70-year-old female who presented with pain and swelling in her right groin. CT scan of the abdomen and pelvis found Amyand’s hernia with evidence of inflammation of the appendiceal tip consistent with appendicitis. Laparoscopic appendectomy and open hernia repair revealed an incarcerated hernia. Using blunt dissection, the inflamed tip of the appendix was found in the femoral canal. The appendix was removed. The patient had a De Garengeot’s hernia, not the Amyand’s hernia initially suspected. Patient was discharged home the following day.

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