Local Infiltration Anaesthesia for Inguinal Herniorrhaphy: A Comparison of two techniques (original) (raw)
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Saudi journal of anaesthesia, 2014
The aim was to evaluate general anesthesia (GA) plus ilioinguinal nerve block (IIB) versus spinal anesthesia (SA) in patients scheduled for ambulatory inguinal hernia repair regarding pain management, anesthesia recovery and reducing potential complications. A double-blind, prospective, randomized, controlled study in patients American Society of Anesthesiologists I-III randomized into two groups: GA plus IIB group, induction of anesthesia with propofol, maintenance with sevoflurane, airway management with laryngeal mask allowing spontaneous ventilation and ultrasound-guided IIB; SA group, patients who underwent spinal block with 2% mepivacaine. The study variables were pain intensity, assessed by visual analog scale, analgesic requirements until hospital discharge, time to ambulation and discharge, postoperative complications-related to both techniques and satisfaction experienced. Thirty-two patients were enrolled; 16 patients in each group. The differences regarding pain were sta...
Comparison of Local, Spinal, and General Anaesthesia for Inguinal Herniorrhaphy
The European Journal of Surgery, 2002
Objective: To compare local, spinal, and general anaesthesia for inguinal herniorraphy in otherwise healthy patients with respect to duration of operation, time in operating room, postoperative pain, complications, rehabilitation, and satisfaction. Design: Prospective randomised controlled trial. Setting: University hospital, Turkey. Subjects: Seventy-ve men with unilateral primary inguinal hernias, Nyhus type II and III, and ASA I and II. Interventions: Lichtenstein repairs with standard local, spinal, or general anaesthesia. Main outcome measures: Duration of operation and anaesthesia, postoperative pain scores, analgesic requirements, complications, length of hospital stay, postoperative rehabilitation, and satisfaction. Results: With local anaesthesia, we recorded shorter time spent in the operating room, lower incidence of nausea and urinary retention, and more satisfaction. In the local and spinal anaesthetic groups, postoperative analgesic requirements and length of hospital stay were less than in the general anaesthesia group. Conclusions: Local anaesthesia is suitable for day-case hernia repair with fewer postoperative problems and less analgesia requirement. Patients also reported greater satisfaction. Local anaesthesia may be preferred to other methods.
Recovery Profiles and Costs of Anesthesia for Outpatient Unilateral Inguinal Herniorrhaphy
Anesthesia & Analgesia, 2000
The use of an ilioinguinal-hypogastric nerve block (IHNB) as part of a monitored anesthesia care (MAC) technique has been associated with a rapid recovery profile for outpatients undergoing inguinal herniorrhaphy procedures. This study was designed to compare the cost-effectiveness of an IHNB-MAC technique with standardized general and spinal anesthetics techniques for inguinal herniorrhaphy in the ambulatory setting. We randomly assigned 81 consenting outpatients to receive IHNB-MAC, general anesthesia, or spinal anesthesia. We evaluated recovery times, 24-h postoperative side effects and associated incremental costs. Compared with general and spinal anesthesia, patients receiving IHNB-MAC had the shortest time-to-home readiness (133 Ϯ 68 min vs 171 Ϯ 40 and 280 Ϯ 83 min), lowest pain score at discharge (15 Ϯ 14 mm vs 39 Ϯ 28 and 34 Ϯ 32 mm), and highest satisfaction at 24-h follow-up (75% vs 36% and 64%). The total anesthetic costs were also the least in the IHNB-MAC group ($132.73 Ϯ 33.80 vs 172.67Ϯ29.82and172.67 Ϯ 29.82 and 172.67Ϯ29.82and164.97 Ϯ 31.03). We concluded that IHNB-MAC is the most costeffective anesthetic technique for outpatients undergoing unilateral inguinal herniorrhaphy with respect to speed of recovery, patient comfort, and associated incremental costs.
Rambam Maimonides Medical Journal, 2016
Abbreviations: BMI, body mass index; BW, body weight; ILI+IHG, ilioinguinal and iliohypogastric nerve block; IV, intravenously; NP scale, nurses' assessment of postoperative pain scale; PACU, postanesthesia care unit; PCA, patientcontrolled analgesia with intravenous morphine; PONV, post-op nausea and vomiting; pre-op, preoperative or preoperatively; post-op, postoperative or postoperatively; PROSPECT, procedure-specific post-op pain management; TAP, posterior transversus abdominis plane block; US, ultrasound. Citation: Stav A, Reytman L, Stav M-Y, Troitsa A, Kirshon M, Alfici R, Dudkiewicz M, Sternberg A. Transversus ABSTRACT Objectives: We hypothesized that preoperative (pre-op) ultrasound (US)-guided posterior transversus abdominis plane block (TAP) and US-guided ilioinguinal and iliohypogastric nerve block (ILI+IHG) will Nerve Blocks for Analgesia Following Open Herniorrhaphy Rambam Maimonides Medical Journal 2 July 2016 Volume 7 Issue 3 e0021
Anaesthesia, 2006
The aim of this study was to compare the efficacy of nerve stimulator guided paravertebral block with ilio-inguinal nerve block in children undergoing inguinal herniorrhaphy. Eighty children were randomly allocated to receive either paravertebral block or ilio-inguinal nerve block. Each block was evaluated in terms of intra-operative haemodynamic stability, postoperative pain scores at rest, on movement and during activity, requirement for supplemental analgesia and parental satisfaction. Haemodynamic stability was maintained significantly better during sac traction in the paravertebral block group (p < 0.005). Pain scores and analgesic consumption were significantly lower in the paravertebral block group during the postoperative follow-up period (p < 0.05). Parental satisfaction (93%vs 69%) and surgeon satisfaction (93%vs 64%) were significantly higher in the paravertebral block group (p < 0.05). Paravertebral blockade improved and prolonged postoperative analgesia, and was associated with greater parental and surgeon satisfaction when compared to ilio-inguinal nerve block.
2015
INTRODUCTION: Conventional spinal anesthesia has been used since 1899 and the most common side effect associated with it is hypotension. Unilateral spinal anesthesia has emerged over time as an alternative to the standard technique and offer benefits in terms of minimal haemodynamic disturbances primarily by limiting the degree of sympathetic block. Patient satisfaction and home readiness is compareable to the bilateral spinal anesthesia. OBJECTIVES: To compare frequencies of hypotension with unilateral versus bilateral spinal anesthesia in patients undergoing inguinal herniorrhaphy. STUDY DESIGN: Randomized controlled trial SETTING: Department of Anesthesia and Intensive Care, Punjab Medical College and affiliated hospitals, Faisalabad. DURATION OF STUDY WITH DATES: Study was carried out over a period of six months from 2012-2011 to 19-06-2012. SUBJECTS AND METHODS: A total of 130 patients (65 patients in each group) were included in this study. In Group-A, patients received bilate...
A comparative study of spinal anaesthesia versus epidural anaesthesia for inguinal hernioplasty
International Journal of Medical Anesthesiology, 2020
Introduction: Inguinal hernia repair is normally implemented under spinal anaesthesia. However, epidural anaesthesia procedure offers constant hemodynamic with early ambulation and less urinary retention, less frequency of nausea and vomiting. We compared efficacy, feasibility and safety of ilioinguinal nerve block for inguinal hernia repair with spinal anaesthesia versus epidural anaesthesia. Material and methods: Hundred adult male patients scheduled for elective inguinal hernia repair were randomized into two groups to receive either spinal anaesthesia or epidural anaesthesia. The total time to perform anaesthetic procedures, time of onset, hemodynamic variations, supplemental sedation, intraoperative fluid requirement, duration of postoperative analgesia and ambulation were compared in both groups. Continuous data are presented as mean±S.D. Unpaired t-test and paired t-test were applied for intergroup and intragroup comparisons respectively. P< 0.05 was taken as significant. Results: Duration to perform the procedure was significantly longer with epidural than spinal block (7.95±0.41 Vs 3.73±0.67 minutes). Intraoperative fluid requirement was statistically higher in Spinal than Epidural (1580±190.1 ml vs 1021.33±77.16 ml) (p< 0.0001). Duration of Surgery was significantly shorter in Spinal as compared to Epidural (85.17±7.82 vs 101.00±10.20 mins.) (p=0.019). Systolic and mean blood pressure showed statistically significant reduction in Spinal as compared to Epidural (19(40%) vs 3(6%)) (p< 0.001). Duration of ambulation was significantly shorter in Epidural as compared to Spinal (3.95±2.57 vs 9.58±0.82 hours) (p< 0.001). Conclusion: Epidural anaesthesia can be a safe alternative to spinal anaesthesia for elective inguinal hernia repair.
Volume 2, Issue 1 : January 2016 – March 2016, 2016
Caudal anaesthesia and ilioinguinal block are effective, safe anaesthetic techniques for paediatric inguinal herniotomy. This review article aims to educate medical students about these techniques by examining their safety and efficacy in paediatric surgery, as well as discussing the relevant anatomy and pharmacology. The roles of general anaesthesia in combination with regional anaesthesia, and that of awake regional anaesthesia, are discussed, as is the administration of caudal adjuvants and concomitant intravenous opioid analgesia.
2023
Aim To assess the efficacy of preemptive analgesia in the form of ultrasound-guided (IIN / IHN) block alone or with lidocaine (5%) patch on (US) acute, chronic postherniorrhaphy pain and patient satisfaction. Patients and methods Preemptive US guided IIN / IHN block was performed on 60 patients (equally distributed into two groups) planned to undergo unilateral inguinal hernia operation under general anesthesia, 30 patients without lidocaine (5%) patch (group I) and 30 patients with lidocaine (5%) patch in the postoperative day 0 (group II). The groups were compared regarding patient satisfaction, intensity of postoperative pain, chronic post-herniorrhaphy pain, and its impact on daily activities. Results There were considerable differences between two groups as regards Douleur Neuropathique en 4 questions as it was higher in group I, P value less than 0.001. There was a significant increase in Brief Pain Inventory short form score postoperatively through 1, 3, and 6 months in group I, P value of 0.033. On the other hand, there were insignificant differences within each group as regards Brief Pain Inventory at 1, 3, and 6 months postoperatively with P values of 0.378, 0.931, and 0.934, respectively. There were insignificant differences regarding the patient's satisfaction and postoperative visual analog scale. Conclusions US guided IIN / IHN block provides good perioperative pain control for inguinal hernia-repair surgeries. Addition of lidocaine (5%) patch may increase patient satisfaction and improve chronic postoperative pain outcome.