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Tumescent local anesthesia in inguinal herniorrhaphy with a PROLENE hernia system: original technique and results
Masato Narita1, Shigeru Sakano, Shogo Okamoto
1Department of Surgery, Shinko Hospital, Kobe, Japan. narinari@kuhp-u.ac.jp
Background:
Local anesthesia (LA) for inguinal herniorrhaphy has many advantages, but its practical use is rare. We presented a new method, tumescent local anesthesia (TLA), for inguinal herniorrhaphy with a PROLENE hernia system (PHS).
Methods:
Sixty-six patients underwent inguinal herniorrhaphy with PHS under TLA of .05% lidocaine and .0125% bupivacaine diluted in normal saline with epinephrine (1:1,000,000) and 10 mEq/L of sodium bicarbonate.
Results:
No patients required conversion to general anesthesia. The mean dose of lidocaine was 188.1 +/- 40.5 mg, and the mean duration of surgery was 73.4 +/- 23.8 minutes. Intraoperative sedation was required in 1.5% of patients, and painkillers in the early postoperative period were required in 13.6%. No recurrence was observed up to 2 years after surgery.
Conclusions:
Our results suggest that the TLA technique is safe and applicable in inguinal herniorrhaphy and may have some beneficial effects regarding intra- and postoperative analgesia.