Inguinal hernia repair

Early ambulation has previously been implicated in transient radicular irritation. However, in a randomized trial there was no difference between early and late mobilization in patients who received intrathecal lidocaine 2% for inguinal hernia repair the incidence was 23% in both groups (256). 

Pettersson N, Emanuelsson BM, Reventlid H, Hahn RG. High-dose ropivacaine wound infiltration for pain relief after inguinal hernia repair a clinical and pharmacokinetic evaluation. Reg Anesth Pain Med 1998 23(2) 189-96. 

MINOR Inguinal hernia repair Colonoscopy Mild febrile illness Mild/moderate nausea and vomiting Gastroenteritis 25 mg of hydrocortisone (or 5 mg of methylpred-nisolone) IV on day of procedure... 

Akyol C, Kocaay E, Orozakunov E, Gene V, Bayram IK, Cakmak A, et al. Outcome of the patients with chronic mesh infection foUowing open inguinal hernia repair. J Korean Surg Soc 2013 84(5) 287-91. 

The postoperative analgesic effect of intravenous tramadol 1 mg/kg 6-hourly for up to 24 hours has been compared with that of intravenous lornoxicam 8 mg immediately postoperatively -I- 8 mg 12 hours later. The two regimens provided similar analgesia after inguinal hernia repair, but one of those who received tramadol (n = 8) had nausea [188 ]. 

Mentes O, Bagci M. Postoperative pain management after inguinal hernia repair lornoxicam versus tramadol. Hernia 2009 13 427-30. 

It is widely assumed that tramnatic injiuy to the nerve is the major cause of post-operative neiu-opathlc pain, but it is probably more complicated than this suggestion. It is also likely that the particular procedure and sensory systems in the surgical field contribute. Additionally, in some patients, continuous inflammatory responses, such as after inguinal hernia repair, drive the chronic response. However, it is the role of peripheral nociceptor sensitization that seems to be at the center of this issue. 

Pre-operative and acute post-operative pain has been considered to play an important role in this condition. Pre-operative pain has been demonstrated in several trials on inguinal hernia repair to be related to the development of persistent post-operative pain. Similar suggestions for this relationship were determined in post-amputation and breast cancer studies. However, a correlation for total hip arthroplasty was not observed. One of the variables that has been discussed is the impact... 

Probably the most obvious way to reduce the development of persistent post-operative pain is to utilize surgical techniques that avoid damage to major nerves. In inguinal hernia repair, laparoscopic procedures as opposed to open procedures where possible can possibly reduce the risk of nerve injury. In addition, lightweight mesh may reduce the inflammatory response following surgery although, as noted above, some... 

Gastrointestinal In a randomized prospective comparison of lomoxicam 16 mg and tramadol 1 mg/kg every 6 hours for 24 hours for postoperative pain after inguinal hernia repair, tramadol caused nausea in 10% [177. ... 

Bozdogan N, Sener M, Caliskan E, Kocum A, Aribogan A. A combination of ketamine and dexmedetomidine sedation with caudal anesthesia during incarcerated inguinal hernia repair in three high-risk infants. Paediatr Anaesth 2008 18(10) 1009-11. 

Chastan P. Tension free open inguinal hernia repair using an innovative self gripping semi-resorbable mesh. 1 Minim Access Surg 2006 3 139-43. 

Entrapment of the femoral nerve is a rare condition resulting from a variety of space-occupying processes in the iliacus compartments, such as hematoma, iliacus abscess, iliopsoas bursitis or iatrogenic complications after vessel cannulation, during fracture fixation with metallic plates or inguinal hernia repair. In severe neuropathy, wasting and weakness of the quadriceps muscle, a reduced knee reflex and... 

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