>Year 2004, Issue 4
Vázquez-Mellado DA, Vázquez CJA, Gutiérrez ÁI, Mayagoitia GJC, Fernández Vázquez-Mellado LA, Cornejo MLM
Local anesthesia versus peridural block in tension-free inguinal repair. Comparative study
Cir Gen 2004; 26 (4)
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Introduction: Tension-free hernioplasties performed under an ambulatory scheme and local anesthesia constitute a standardized practice in many countries, but ours is an exception.
Objective: To compare local anesthesia (LA) versus peridural block (PDB) during a tension-free inguinal hernioplasty performed as ambulatory surgery.
Setting: Private second health care hospital.
Patients and methods: Comparative, longitudinal, and prospective study, with a non-randomized chronological distribution. Fifty three tension-free plasties were performed under PDB and 78 under LA. All patients were evaluated through a questionnaire during the immediate post-operative period, to document the intensity and duration of pain.
Results: In the LA group pain was absent or moderate in 80% of the patients (74/78), in the PDB group the same pain intensity was found in 81% of the patients (43/53), revealing no statistically significant difference. Intense to very intense pain was found in 18% of the PDB (10/53) patients and in 5% of the LA group (4/78), revealing a statistical significance (p ‹ 0.025). In group LA, postoperative pain lasted 7 or fewer days in 69.7% (54/78) as compared to 64% of group PDB (34/53). The largest duration, over 7 days, was found in 30% of group LA as compared to 36% in group PDB (19/53) (p ‹ 0.01).
Conclusion: Patients of group LA depicted less intensity and duration of postoperative pain as compared to the PDB group in tension-free inguinal hernioplasties.
||Inguinal hernia, hernioplasty, local anesthesia.
Paajanen H. Lichtenstein inguinal herniorrhaphy under local infiltration, anaesthesia a rapid outpatient procedure. Ann Chir Gynaecol 2001; 90 (Suppl 215): 51-4.
Picchio M, Lombardi A, Zolovkins A. Michelson M, La Torre G. Tension-free laparoscopic and open hernia repair: Randomized controlled trial of early results. World J Surg 1999; 23: 1004-7.
Kendell J, Wildsmith JA, Gray IG. Costing anaesthetic practice. An economic comparison of regional and general anaesthesia for varicose vein and inguinal hernia surgery. Anaesthesia 2000; 55: 1106-13.
Paron L, Lombardo G, Tomaselli F. Treatment of inguinal hernia. Case reports. Minerva Chir 2000; 55: 235-8.
Tani F, Coratti A, De Martino A, Criscuolo S, Pede O, Testi W, et al. Locoregional anesthesia in inguinal hernia surgery. Minerva Anestesiol 2000; 66: 201-6.
Cowdin HP Jr, Triebwasser AS. Anesthetic considerations in the management of abdominal wall hernia. In: Fitzgibbons RJ Jr, Greenburg AG, editors. Nyhus and Condon’s hernia. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 515-29.
Cunningham J. The physiology and anatomy of chronic pain after inguinal herniorrhaphy. In: Fitzgibbons RJ Jr, Greenburg AG, editors. Nyhus Condon´s, hernia. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 297-306.
>Year 2004, Issue 4