Tumescent local anesthesia in inguinal herniorrhaphy with a PROLENE hernia system: original technique and results

Am J Surg. 2009 Aug;198(2):e27-31. doi: 10.1016/j.amjsurg.2008.11.045.

Abstract

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.

MeSH terms

  • Anesthetics, Local / therapeutic use*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Bupivacaine / therapeutic use*
  • Hernia, Inguinal / surgery*
  • Humans
  • Injections
  • Lidocaine / therapeutic use*
  • Male
  • Middle Aged
  • Nerve Block
  • Pain, Postoperative / prevention & control
  • Polypropylenes
  • Surgical Mesh*

Substances

  • Anesthetics, Local
  • Anti-Inflammatory Agents, Non-Steroidal
  • Polypropylenes
  • Lidocaine
  • Bupivacaine