IntroductionThis study aims to compare Lichenstein's repair performed under regional anaesthesia and local anaesthesia.
MethodsThis prospective study included two groups of 31 patients each with an uncomplicated inguinal hernia from surgical units of KMC affiliated hospitals. All patients underwent Lichenstein's tension-free repair either under spinal anaesthesia (group 1) or under local anaesthesia (group 2). Results from both groups were compiled and analysed.
ResultsMean age was 50.45 (SD 16.49) in group 1 and 50.61 (SD 12.04) in group 2. Median time taken for surgery was less under local anaesthesia (1.17 versus 1.5 hours). Postoperative pain was less in the local anaesthesia group at 24, 48 hours after surgery, and after 2 weeks of discharge. Group 1 had higher cases of urinary retention.
ConclusionLichenstein's repair under local anaesthesia was better concerning post-operative pain, complications and hospital stay.
Intra-operative assessment of bowel vascularity is often needed during emergent surgery. An objective test to determine the viability could reduce postoperative ischemic complications. Indocyanine green dye has been used for assessing bowel vascularity in colorectal surgery. The following study involving two patients demonstrates its use for assessing the viability of bowel in obstructed hernias after intraoperative intravenous injection. Stryker 1588 AIM laparoscopic setup was used for intraoperative fluorescence. In both cases, dusky areas were noted over the obstructed bowel segment on visual inspection. However, satisfactory fluorescence was seen after dye injection, and hence mesh repair was done without resecting the bowel. All the patients had a good post-operative recovery. Indocyanine green fluorescence may be a good modality to intraoperatively assess bowel vascularity.
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