Skip to main content
Log in

Pain during and after-hernioplasty in raquidian or locorregional anesthesia by locking peripheral nerves

  • Original Article
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

Purpose

To analyze pain scores after surgery in a group of patients submitted to inguinal hernia repair under peripheral nerve block with local or spinal anesthesia.

Methods

Fifty patients were divided into two groups (both with 25 patients each). In the first group the patients were submitted to herniorrhaphy under peripheral block and local anesthesia (LG) and in the other group the patients were submitted to the same procedure under spinal anesthesia (RG). The pain was assessed using the international visual analog pain scale at four different moments. The analysis cost of the procedure was performed using the hospital’s average final cost, without including medical expenses.

Results

The groups were homogeneous in relation to the epidemiological and clinical features. There was no significant difference between the pain in the intraoperative period and in the return visit for both groups (p = 0.17 and p = 0.18). In the immediate postoperative period, both groups reported no pain at all. In general, the RG reported a greater pain score (16% for RG and 12% for LG). Complications were more frequent in patients submitted to spinal anesthesia (40% versus 8%) (p = 0.008). The surgical time was higher in the LG (39.3 ± 9.2 min) versus (28.7 ± 7.5 min) (p = 0.01). The average final cost of the procedure was US$ 100.98 for the LG and US$ 166.19 for the RG (p = 0.00).

Conclusion

The inguinal hernioplastia under local anesthesia plus sedation is a safe method, with a low incidence of complications, great acceptance by patients and less expensive.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. O'Rourke MG, O'Rourke TR (2012) Inguinal hernia: aetiology, diagnosis, post-repair pain and compensation. ANZ J Surg 82:201–206

    Article  Google Scholar 

  2. Prakash D et al (2017) Local anaesthesia versus spinal anaesthesia in inguinal hernia repair: a systematic review and meta-analysis. Surgeon 15:47–57

    Article  Google Scholar 

  3. Bourgouin S et al (2017) Feasibility and limits of inguinal hernia repair under local anaesthesia in a limited resource environment: a prospective controlled study. Hernia 21:749–757

    Article  CAS  Google Scholar 

  4. Nikkolo C, Lepner U (2016) Chronic pain after open inguinal hernia repair. Postgrad Med 128:69–75

    Article  Google Scholar 

  5. Salma U et al (2015) A comparison of post operative pain and hospital stay between Lichtenstein’s repair and Laparoscopic Transabdominal Preperitoneal (TAPP) repair of inguinal hernia: a randomized controlled trial. Pak J Med Sci 31:1062–1066

    PubMed  PubMed Central  Google Scholar 

  6. Ertem M et al (2015) Topic: inguinal hernia—post op chronic pain: incidence, evaluation, legal consequences, therapy, follow up. Hernia 19(Suppl 1):S361

    Article  Google Scholar 

  7. Wu CC et al (2014) Local anesthetic infusion pump for pain management following open inguinal hernia repair: a meta-analysis. Int J Surg 12:245–250

    Article  Google Scholar 

  8. Neto EVL et al (2003) Resultados imediatos da herniorrafia inguinal com anestesia local associada com sedação. Acta Cir Bras 18:7

    Google Scholar 

  9. Nesioonpour S et al (2013) The effect of preemptive analgesia with bupivacaine on postoperative pain of inguinal hernia repair under spinal anesthesia: a randomized clinical trial. Hernia 17:465–470

    Article  Google Scholar 

  10. Donati M et al (2013) Incidence of pain after inguinal hernia repair in the elderly. A retrospective historical cohort evaluation of 18-years’ experience with a mesh and plug inguinal hernia repair method on about 3000 patients. BMC Surg 13(Suppl 2):S19

    Article  Google Scholar 

  11. Campanelli G et al (2013) Surgical treatment of chronic pain after inguinal hernia repair. Hernia 17:347–353

    Article  CAS  Google Scholar 

  12. Britton DC (2013) Prospective study of pain, quality of life and economic impact of open inguinal hernia repair (Br J Surg 2013; 100: 1483–1488). Br J Surg 100:1489

    Article  CAS  Google Scholar 

  13. Shaikh AR et al (2012) Inguinal mesh hernioplasty under local anaesthesia. J Pak Med Assoc 62:566–9

    PubMed  Google Scholar 

  14. Voropai DA, Akkersdijk WL (2015) Nerve management and chronic pain after open inguinal hernia repair. Ann Surg 261:e11–12

    Article  Google Scholar 

  15. Kurmann A et al (2015) Effect of intraoperative infiltration with local anesthesia on the development of chronic pain after inguinal hernia repair: a randomized, triple-blinded, placebo-controlled trial. Surgery 157:144–154

    Article  Google Scholar 

  16. Callesen T (2003) Inguinal hernia repair: anaesthesia, pain and convalescence. Dan Med Bull 50:203–218

    PubMed  Google Scholar 

  17. Schwab R et al (2004) Systemic inflammatory response after endoscopic (TEP) vs Shouldice groin hernia repair. Hernia 8:226–232

    Article  CAS  Google Scholar 

  18. Kulacoglu H et al (2007) Prospective comparison of local, spinal, and general anesthesia regarding oxidative stress following Lichtenstein". Bratisl Lek Listy 108:335–339

    CAS  PubMed  Google Scholar 

  19. Rahr HB et al (2006) Coagulation, inflammatory, and stress responses in a randomized comparison of open and laparoscopic repair of recurrent inguinal hernia. Surg Endosc 20:468–472

    Article  CAS  Google Scholar 

Download references

Funding

No funding.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to P. M. F. de Souza.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This research was approved by the CEP Research Ethics Committee of the Santa Casa Institute of Teaching and Research of Belo Horizonte, under the protocol registered under the number of CAE: 42810815.3.0000.5138.

Statement of human and animal rights

All procedures and protocols adopted in this research involving human beings were performed according to the ethical standards of the institutional and/or national reserarch committee and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authours.

Informed consent

Informed Consent was obtained from all individuals who were included in this study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

de Souza, P.M.F., Ferreira, L.C., Marinari, L.F.S. et al. Pain during and after-hernioplasty in raquidian or locorregional anesthesia by locking peripheral nerves. Hernia 23, 1065–1069 (2019). https://doi.org/10.1007/s10029-019-02039-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-019-02039-y

Keywords

Navigation