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Local anesthesia for inguinal hernia repair step-by-step procedure
P K Amid1, A G Shulman, I L Lichtenstein
1Department of Surgery, Lichtenstein Hernia Institute, Harbor-UCLA Research and Education Institute.
Annals of Surgery
|December 1, 1994
Summary
A new six-step infiltration technique provides effective local anesthesia and lasting pain relief for groin hernia repair, using minimal anesthetic solution. This safe and economical method is ideal for adult inguinal hernia surgery.
Area of Science:
- Surgical Anesthesiology
- Hernia Repair Techniques
- Pain Management
Background:
- Over 12,000 groin hernia repairs performed under local anesthesia at Lichtenstein Hernia Institute over 20 years.
- Shift from field block to infiltration technique due to time, volume, and efficacy limitations of field block.
- Field block anesthesia sometimes resulted in unsatisfactory anesthesia and nerve-related postoperative pain.
Purpose of the Study:
- Introduce a simple six-step infiltration technique for local anesthesia in groin hernia repair.
- Achieve satisfactory anesthesia and prolonged postoperative analgesia.
- Minimize local anesthetic solution volume.
Main Methods:
- A six-step infiltration technique was employed.
- Over 12,000 adult patients with reducible groin hernias underwent operations.
- Procedures were conducted in a private practice setting within general hospitals.
Main Results:
- The technique resulted in satisfactory local anesthesia and prolonged postoperative analgesia.
- A maximum of 30-40 mL of local anesthetic solution was required.
- Over 12,000 patients underwent successful operations under local anesthesia without complications.
Conclusions:
- Local anesthesia is the preferred choice for reducible adult inguinal hernia repair due to safety, simplicity, efficacy, and cost-effectiveness.
- The infiltration technique provides longer postoperative analgesia by potentially inhibiting nociceptive molecule buildup.
- This method offers effective pain control in the postoperative period without postanesthesia side effects.