Changes of abdominal wall mechanics and pain after tension-free inguinal hernia repair with polypropylene mesh / 中国组织工程研究

BACKGROUND: Chronic pain after tension-free inguinal hernia repair is a common postoperative complication. An important cause of chronic pain is nerve injury. OBJECTIVE: To observe the effect of iliohypogastric nerve preposition on chronic pain after inguinal hernia repair and analyze its mechanics. METHODS: Totally 76 male inguinal hernia patients, from August 2013 to November 2016, aged 36-95 years in Second People’s Hospital of Lianyungang were selected. The patients were all treated with large-size polypropylene non-absorbable mesh insertion. The iliohypogastric nerve was placed in front of the mesh. Pain was followed up at 3, 6, and 12 months after operation. This study was approved by the Ethics Committee of Second People’s Hospital of Lianyungang. RESULTS AND CONCLUSION: (1) No chronic pain or recurrence was found in the 76 patients at 3, 6 and 12 months after surgery. (2) The pressure included vertical pressure and tangent pressure formed from intra-abdominal pressure on abdominal wall, directly affecting abdominal wall and artificial repair materials. This was the basic cause of the relative mechanical relationship between nerve and mesh. (3) The results showed that the tension-free inguinal hernia repair with the iliohypogastric nerve preposition could reduce the incidence of postoperative chronic pain, which may be related to the effect of postoperative abdominal pressure on tissue repair, especially the repair around the mesh.

A Study Of Variations In Iliohypogastric And Ilioinguinal Nerves In Human Adults

Introduction: Lumbar plexus is one of the main nervous pathways supplying the lower limb which is bound toshow variations. Surgeons should be aware of these variations to avoid possible injuries to the structure andtheir consequences. This study was conducted to observe the formation of Iliohypogastric nerve and IlioinguinalnerveMaterial and methods: Dissection of 40 bilateral lumbar plexuses from formalin fixed adult human cadaversprocured from department of anatomy JJMMC Davangere.Results: Many significant variations were found in the anatomy of the iliohypogastric and ilioinguinal nerve.Conclusion: Knowledge of the variations in the branching pattern and formation of the lumbar plexus is essentialto prevent nerve injury during routine surgical procedures like inguinal hernia surgery, low transverse incisionof gynecological procedures

Hernioplastia inguinal con anestesia local y bloqueo nervioso: experiencia en el hospital Dr. Francisco Antonio Rísquez / Inguinal hernioplastia with local anesthesia and nervous block: experience in the hospital Dr. Francisco Antonio Rísquez

La anestesia local es una opción válida para realizar procedimientos quirúrgicos de pequeña o mediana consideración. Permite la deambulación y el alta precoz. Objetivo: Evaluar los resultados del uso de anestesia local y bloqueo de los nervios ilioinguinal e iliohipogástrico, en pacientes a quienes se les realizó cura operatoria de hernia inguinal, en el Servicio de Cirugía del Hospital "Dr. Francisco Antonio Rísquez", en el periodo octubre 2017 - octubre 2018. Métodos: Estudio prospectivo, transversal que incluyó 23 pacientes que aceptaron se le realizara la hernioplastia con anestesia local. Resultados: Se realizaron 46 curas operatorias de hernia inguinal, y en 23 se realizó con anestesia local (50 %). Predominaron pacientes masculinos (87 %), con una distribución bimodal en relación a la edad (26,1 % entre 30 y 39 años y entre 70 a 79 años). La hernia inguinal derecha fue la más frecuente con el 40 % (10 casos). Todos los pacientes reportaron una puntuación de 0-1 en la escala visual análoga, tanto en el transoperatorio como en el posoperatorio. El 96% de los pacientes logró una deambulación precoz (antes de 4 horas) y todos toleraron la vía oral antes de las dos horas en el posoperatorio. No se observó ninguna complicación en el transoperatorio; hubo 1 recidiva. Conclusiones: La cura operatoria de hernia inguinal con anestesia local, resultó ser efectiva y bien tolerada por los pacientes, brindando un reintegro casi inmediato a sus actividades, lo que representa una disminución en los costos intrahospitalarios(AU)

Local anesthesia is an option to perform surgical procedures of small or medium account. It allows the ambulation, and early discharge. Objective: To evaluate the results of the use of local anesthesia and nerve block ilioinguinal and iliohypogastric, in patients who underwent surgical cure of inguinal hernia, surgery of the Hospital "Dr. Francisco Antonio Rísquez" service, in the October 2017 period - October 2018. Methods: Prospective, cross-sectional study involving 23 patients who accepted it will be the hernioplasty under local anesthesia. Results: 46 surgical cure of inguinal hernia were performed, and in 23 was held with local anesthesia (50%). Dominated male patients (87%), with a bimodal distribution in relation to the age (26.1% between 30 and 39 years and between 70 to 79 years). Right inguinal hernia was the most frequent with 40% (10 cases). All patients reported a score of 0-1 in the Visual analog escale, both in the intraoperative and postoperative. 96% of patients achieved early ambulation (within 4 hours) and all tolerated the mouth before the two hours in the postoperative. There were no complications in the intraoperative; there was 1 recurrence. Conclusions: e surgical cure of inguinal hernia under local anesthesia, proved to be effective and well tolerated by the patients, providing a return almost immediately to their activities, which represents a decrease in hospital costs(AU)

Ilioinguinal and iliohypogastric nerve block / Монголын Анагаах Ухаан

Ilioinguinal (II) and iliohypogastric (IH) nerve blocks are often performed to provide intra- andpostoperative analgesia for hernia repair in children and adults. Several techniques are describedin the literature. Recently an ultrasound guided technique for II and IH nerve blocks were describedin the international journals. The block success rates are variable specially for using anatomicallandmark blind techniques. In the present study, the anatomical variations in course of the II andIH nerves are described. Knowledge of the course of these nerves in the inguinal region, and anunderstanding of variations seen in their topography, can decrease the incidence of postoperativecomplications and adverse effects. Ultrasound guidance of block performance will shorten the time,reduce the number of needle passes and shorten the block onset time. Blocks may be performedusing lower local anesthetic doses.

A Comparison between Ilioinguinal and Iliohypogastric Nerve Block and Infiltration of Local Anesthetics for Postoperative Pain after Inguinal Herniorrhaphy in Children / 소아외과

The present study compared the postoperative analgesic effects of ilioinguinal and iliohypogastric nerve block with infiltration of local anesthetics (bupivacaine) into the wound in children after inguinal hernia repair. Ninety children below 7 years old who were scheduled elective inguinal hernia repair were randomly allocated into one of three groups. The patients in nerve block (NB) group, ilioinguinal and iliohypogastric nerve block was done with 0.5 mL/kg of 0.25% bupivacaine. The patients in infiltration of local anesthetics (LI) group, 0.5 mL/kg of 0.25% bupivacaine was infiltrated into the wound after surgery. The patients in control group were allocated as a Control group. Postoperative pain was assessed at 1, 3, 5, and 24 hours after operation with FLACC scale and additional analgesic consumption were counted. The three groups were not significantly different in age, sex, body weight, and duration of operation. Pain scores at 1 hour and 3 hours after operation were significantly higher in Control group than in NB group and LI group (p<0.01), whereas there were no difference between NB group and LI group. The rescue analgesics administration was significantly higher in Control group (n=11) than in NB group (n=6) and LI group (n=7) (p<0.05). There were 2 cases of transient femoral nerve palsy in NB group. Both of ilioinguinal and iliohypogastric nerve block and infiltration of local anesthetics into the wound provided effective postoperative analgesia in early postoperative period following inguinal hernia repair in children. But no difference between the two methods. Technically, infiltration of local anesthetics into the wound was easier and safer than ilioinguinal and iliohypogastric nerve block.

Combined epidural anesthesia and ultrasound guided peripheral nerve block for wound revision in a patient with peripartum cardiomyopathy: A case report / 대한마취과학회지

Peripartum cardiomyopathy (PPCM) is a rare complication that occurs between the late stage of pregnancy and six months after delivery. PPCM presents as symptoms of left ventricular dysfunction and it can be fatal unless treated promptly. Furthermore, anesthesia and surgery in such patients is a large challenge to anesthesiologists. First and foremost, the maintenance of stable hemodynamics is a major concern. We report a case of combined lumbar epidural anesthesia and both ilioinguinal and iliohypogastric nerve block under ultrasound guided for a wound revision in a 37-year-old woman diagnosed with PPCM after an emergency cesarean section.

Comparison of Different Analgesia Methods after Pediatric Half Inguinal Hernia Repair / 实用儿科临床杂志

ObjectiveTo compare the efficacy and side effects of ilioinguinal/iliohypogastric nerve blockades and rectal paracetamol after pediatric inguinal hernia repair.MethodsNinety children undergoing half inguinal hernia repair were randomly divided into 3 groups:nerve block group(n=30),paracetamol group(n=30) and control group(n=30).After basal anesthesia,ilioinguinal/iliohypogastric nerve blockades was administed in nerve block group,paracetamol group received rectal paracetamol,control group had not any medication.Every child was oberserved 1,3,6,8 h postoperatively for pain score,overall satisfaction were evaluated by parents,furthermore,evaluation of distress for children such as nausea,vomiting and delayed femoral nerve palsy was made.ResultsPain scores were significantly lower in nerve block group and paracetamol group during the postoperative follow-up 1,3 and 6 h.Overall satisfaction in nerve block group and paracetamol group were significantly higher than control group.The incidence of delayed femoral nerve palsy in nerve block group was higher than paracetamol group(F=4.22P