Local anesthesia for inguinal hernia repair in adolescents

Area of Science:

• Pediatric Surgery
• Anesthesiology
• Ambulatory Surgery

Background:

• Local anesthesia is standard for adult inguinal hernia repair in outpatient settings.
• Guidelines and reports on anesthesia for adolescent inguinal hernia surgery are lacking.
• This study explores local anesthesia with intravenous sedation for adolescent inguinal hernia repair.

Purpose of the Study:

• To evaluate the feasibility and safety of local anesthesia combined with intravenous sedation for inguinal hernia surgery in adolescents.
• To describe the initial experience with this anesthetic approach in a day-surgery facility.

Main Methods:

• Retrospective review of 14 adolescent patients (aged 12-17) undergoing inguinal hernia surgery.
• Administration of midazolam and fentanyl or ketamine for sedation, followed by local anesthetic (lignocaine and bupivacaine) infiltration.
• Surgeons administered local anesthesia, with anesthesiologist managing sedation.

Main Results:

• All 14 male adolescent patients (15 repairs) completed surgery successfully using local anesthesia and sedation.
• No patients required conversion to general anesthesia.
• Mean discharge time was under 2 hours, with no reported complications or postoperative complaints.

Conclusions:

• Local anesthesia with intravenous sedation appears to be a safe and feasible option for adolescent inguinal hernia repair.
• Further prospective studies are warranted to confirm these findings and establish clear guidelines.