Incidence of Inguinal Herniotomy in Children. A Prospective Study at a Regional Hospital

Background: Inguinal hernia is one of the most common surgical conditions in children. Herniotomy is the surgery performed for a pediatric hernia and hydrocele. This study was done to know the demography and outcome of pediatric herniotomy at our center. Materials and methods: A prospective study on patients who underwent herniotomy from 10th May 2016 to 9th May 2017 was conducted at the Department of Surgery, Western Regional Hospital. Results: During this study 112 patients underwent herniotomy out of which 98 were boys while 14 were girls. 59(52.67%) patients had unilateral hernia, 40(35.71%) had unilateral hydrocele and 13(11.6%) had bilateral condition among which 8 had hernia and 5 had hydrocele. 69(61.6%) patients presented with a right-sided, 30(26.7%) with left-sided, and 13(11.6%) with bilateral conditions. 13 patients (11.6%) presented at the emergency with irreducible hernia. Two among the patient who underwent emergency herniotomy developed postoperative wound infection and one among the elective surgery had recurrence. Conclusion: Pediatric inguinal hernias and hydroceles are often difficult to diagnose clinically. Herniotomy is often performed by junior consultants who have no specific training in pediatric surgery. Timely planning of surgery is required to minimize preoperative complications.

Dexmedetomidine Addition For Pediatric Hernia Repair: A Meta-Analysis of Randomized Controlled Studies

Introduction: The efficacy of dexmedetomidine addition for pain control after pediatric hernia repair remains controversial. We conduct a systematic review and meta-analysis to explore the influence of dexmedetomidine addition on pain management for pediatric hernia repair.Methods: We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through March 2020 for randomized controlled trials (RCTs) assessing the effect of dexmedetomidine addition on pain management for pediatric hernia repair. This meta-analysis is performed using the random-effect model.Results: Six RCTs are included in the meta-analysis. Overall, compared with control group for pediatric hernia repair, dexmedetomidine addition is associated with significantly reduced analgesic consumption (SMD=-1.0; 95% CI=-1.40 to -0.61; P<0.00001) and number of rescue analgesics (SMD=0.16; 95% CI=0.06 to 0.41; P=0.0002), prolonged time to first analgesia (SMD=8.16; 95% CI=4.58 to 11.73; P<0.00001) and decreased the incidence of emergence agitation (RR=0.12; 95% CI=0.03 to 0.44; P=0.001), but has no obvious impact on pain scores at 1 h (SMD=-2.00; 95% CI=-5.78 to 1.79; P=0.30) or 2 h (SMD=-0.73; 95% CI=-2.33 to 0.87; P=0.37).Conclusions: Dexmedetomidine addition is beneficial to pain control after pediatric hernia repair.