Abstract
Step-by-step local anesthetic infiltration technique is easy to apply, with low complication and high patient satisfaction rates. The technique is described here in detail. It is begun with subdermal and intradermal injections of a prepared solution. Eight mililiters of local anesthetic is given under the external oblique aponeurosis for the main infiltration of the inguinal floor. Extra small doses can be given at the pubic corner, into the spermatic cord and other areas, if needed.
Keywords:
Local anesthesia, infiltration, hernia, bupivacaine, lidocaine
References
1
Fitzgibbons RJ, Richards AT, Quinn TH. Open hernia repair. In: Souba WS, Mitchell P, Fink MP, Jurkovich GJ, Kaiser LR, Pearce WH, Pemberton JH, Soper NJ, eds. ACS Surgery: Principles and Practice. 6th ed. Philadelphia: Decker Publishing Inc 2002; 828-849.
2
Kulacoglu H, Ozdogan M, Gurer A, et al. Prospective comparison of local, spinal, and general types of anaesthesia regarding oxidative stress following Lichtenstein hernia repair. Bratisl Lek Listy 2007; 108: 335-339.
3
Kulacoglu H, Ozyaylali I, Yazicioglu D. Factors determining the doses of local anaesthetic agents in unilateral inguinal hernia repair. Hernia 2009; 13: 511-516. doi.org/10.1007/s10029-009-0513-2
4
Kulacoglu H, Alptekin A. Current options in local anesthesia for groin hernia repairs. Acta Chir Iugosl 2011; 58: 25-35. doi.org/10.2298/ACI1103025K
5
Kulacoglu H. Current options in inguinal hernia repair in adult patients. Hippokratia 2011; 15: 223-231.
6
Gultekin FA, Kurukahvecioglu O, Karamercan A, et al. A prospective comparison of local and spinal anesthesia for inguinal hernia repair. Hernia 2007; 11: 153-156. doi.org/10.1007/s10029-006-0166-3
7
Faas CL, Acosta FJ, Campbell MD, et al. The effects of spinal anesthesia vs epidural anesthesia on 3 potential postoperative complications: pain, urinary retention, and mobility following inguinal herniorrhaphy. AANA J 2002; 70: 441-447.
8
Simons MP, Aufenacker T, Bay-Nielsen M, et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 2009; 13: 343-403. doi.org/10.1007/s10029-009-0529-7
9
Glassow F. Short-stay surgery (Shouldice technique) for repair of inguinal hernia. Ann R Coll Surg Engl 1976; 58: 133-139.
10
Amid PK, Shulman AG, Lichtenstein IL. Local anesthesia for inguinal hernia repair step-by-step procedure. Ann Surg 1994; 220: 735-737. doi.org/10.1097/00000658-199412000-00004
11
Kingsnorth A. Local anaesthetic hernia repair: gold Standard for one and all. World J Surg 2009; 33: 142-144. doi.org/10.1007/s00268-008-9790-7
12
Kurzer M, Belsham PA, Kark AE. The Lichtenstein repair for groin hernias. Surg Clin North Am 2003; 83: 1099-1117. doi.org/10.1016/S0039-6109(03)00134-8
13
Amid PK. Lichtenstein tension-free hernioplasty: its inception, evolution, and principles. Hernia 2004; 8: 1-7. doi.org/10.1007/s10029-003-0160-y
14
Kehlet H, Bay Nielsen M. Anaesthetic practice for groin hernia repair-a nation-wide study in Denmark 1998-2003. Acta Anaesthesiol Scand 2005; 49: 143-146. doi.org/10.1111/j. 1399-6576.2004.00600.x
15
Callesen T. Inguinal hernia repair: anaesthesia, pain and convalescence. Dan Med Bull 2003; 50: 203-218.
16
Seker G, Kulacoglu H. The acceptance rate of local anaesthesia for elective inguinal hernia repair among the surgeons working in a teaching hospital. J Coll Physicians Surg Pak 2012; 22: 126-127.
17
Rosario DJ, Skinner PP, Raftery AT. Transient femoral nerve palsy complicating preoperative ilioinguinal nerve blockade for inguinal herniorrhaphy. Br J Surg 1994; 81: 897. doi.org/10.1002/bjs.1800810634
18
Reid TD, Sanjay P, Woodward A. Local anesthetic hernia repair in overweight and obese patients. World J Surg 2009; 33: 138-141. doi.org/10.1007/s00268-008-9743-1
19
Jöhr M, Sossai R. Colonic puncture during ilioinguinal nerve block in a child. Anesth Analg 1999; 88: 1051-1052. doi.org/10.1213/00000539-199905000-00015
20
Shipton EA. New formulations of local anaesthetics-part I. Anesthesiol Res Pract 2012; 2012: 546409. doi: 10.1155/2012/546409
21
Kenkel JM, Lipschitz AH, Shepherd G, et al. Pharmacokinetics and safety of lidocaine and monoethylglycinexylidide in liposuction: a microdialysis study. Plast Reconstr Surg 2004; 114: 516-526. doi.org/10.1097/01.PRS.0000128423.84607.61
22
Covino BG, Wildsmith JAW. Clinical pharmacology of local anaesthetic agents. In: Cousins MJ, Bridenbaugh PO, eds. Neural Blockade in Clinical Anesthesia and Management of Pain. Philadelphia: Lippincott-Raven, 1998; 97-128.
23
Rosenberg PH, Veering BT, Urmey WF. Maximum recommended doses of local anaesthetics: a multifactorial concept. Reg Anesth Pain Med 2004; 29: 564-575. doi.org/10.1016/j.rapm.2004.08.003
24
Ozyaylali I, Yazicioglu D, Kulacoglu H. How to avoid leg weakness after local anesthesia for inguinal hernia repair. 30th International Congress of the European Hernia Society, 7-10 May 2008, Sevilla, Spain.