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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
ORIGINAL ARTICLES ANESTHESIOLOGY
Minerva Anestesiologica 2000 April;66(4):201-6
Local anesthesia for inguinal hernia surgery
Tani F., Coratti A., De Martino A., Criscuolo S. *, Pede O. *, Testi W., Belcastro M., Ranalli M., Lucenti Fei A., Caloni C., Coratti G. *, Mancini S.
Università degli Studi - Siena Istituto di Chirurgia Generale e Specialità Chirurgiche,
*Istituto di Anestesia e Rianimazione
Local anesthesia for inguinal hernia surgery.
Background. It is a current opinion that local anesthesia (LA) is the primary choice in surgical treatment of the inguinal region, particularly herniorrhaphy. The LA technique personally used for herniorrhaphy is described: it consists of iliohypogastric, ilioinguinal and genito-femoral nerve blocks, and incision line anesthetic infiltration.
Methods. From January 1998 to April 1999, 95 patients underwent inguinal herniorrhaphy employing LA: 77 (81%) in elective surgery, 18 (19%) in emergency; 2 cases with bilateral hernia (97 total LA procedures).
Results. Partial success was obtained in only 8 cases (8.4%), which required an association with a hypnotic drug (“blended anesthesia”: propofol or midazolam): there were no cases of conversion to general anesthesia. Specific complications of local anesthetic drugs infiltration developped in 8 cases on 97 LA procedures (8.2%), but none required reoperation: 6 inguinal hematomas, 1 female external genitalia hematoma, 1 hematocele.
Conclusions. In conclusion, it is stressed that LA is the technique of choice in herniorrhaphy and surgery of other inguinal pathologies, associating high success rates, rare complications and rapid dismissal: this allows for easy management of the patients and a very important reduction of sanitary costs. The association of LA-hypnotic drugs (blended anesthesia) represents another important resource, since it avoids general anesthesia in many cases and allows a rapid psychophysical recovery.