TY - JOUR
T1 - Abdominal peripheral nerve block as the only anesthetic technique for totally extraperitoneal endoscopic inguinal hernia repair
T2 - Two case reports
AU - Kwon, Woojin
AU - Bang, Seunguk
AU - Soh, Hyojung
AU - Jeong, Won Jun
AU - Lee, Sang Chul
AU - Choi, Byung Jo
N1 - Publisher Copyright:
Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2018/6
Y1 - 2018/6
N2 - Rationale: Laparoscopic totally extraperitoneal (TEP) inguinal hernia repair is a rapidly evolving, minimally invasive treatment modality for inguinal hernia. Compared with open hernia repair, this method requires a smaller incision, has cosmetic advantages, and facilitates rapid recovery and early return to daily activities because of less postoperative pain. Because general anesthesia is essential for TEP hernia repair, it cannot be performed on patients who have an increased risk of developing complications when placed under general anesthesia. Patient concerns: We report 2 cases of single-port laparoscopic TEP (SP TEP) that were performed using only an abdominal peripheral nerve block (PNB) at our institute. General anesthesia and neuraxial block were dangerous for both patients owing to severe heart failure and severe chronic obstructive pulmonary disease (COPD). Diagnoses: They were diagnosed with an inguinal hernia requiring surgery. Interventions: Hence, the anesthesiologist and surgeon decided to attempt a PNB to avoid complications from general anesthesia and allow faster recovery. An ipsilateral transversus abdominis plane block as well as a rectus sheath block and inguinal canal block were administered via ultrasound guidance. Outcomes: The patients did not report any pain, and no rescue drug was administrated. The operation times were 65 and 62minutes in patients 1 and 2, respectively. No intraoperative complications were noted. Patient 1 was discharged the day after the surgery, whereas patient 2 was discharged on the same day as the surgery. Lessons: TEP hernia repair using abdominal PNB anesthesia seemed to be a safe and feasible technique without causing any additional complications. However, the use of abdominal PNB anesthesia alone for TEP hernia repair as an alternative to general anesthesia requires further investigation using a larger cohort.
AB - Rationale: Laparoscopic totally extraperitoneal (TEP) inguinal hernia repair is a rapidly evolving, minimally invasive treatment modality for inguinal hernia. Compared with open hernia repair, this method requires a smaller incision, has cosmetic advantages, and facilitates rapid recovery and early return to daily activities because of less postoperative pain. Because general anesthesia is essential for TEP hernia repair, it cannot be performed on patients who have an increased risk of developing complications when placed under general anesthesia. Patient concerns: We report 2 cases of single-port laparoscopic TEP (SP TEP) that were performed using only an abdominal peripheral nerve block (PNB) at our institute. General anesthesia and neuraxial block were dangerous for both patients owing to severe heart failure and severe chronic obstructive pulmonary disease (COPD). Diagnoses: They were diagnosed with an inguinal hernia requiring surgery. Interventions: Hence, the anesthesiologist and surgeon decided to attempt a PNB to avoid complications from general anesthesia and allow faster recovery. An ipsilateral transversus abdominis plane block as well as a rectus sheath block and inguinal canal block were administered via ultrasound guidance. Outcomes: The patients did not report any pain, and no rescue drug was administrated. The operation times were 65 and 62minutes in patients 1 and 2, respectively. No intraoperative complications were noted. Patient 1 was discharged the day after the surgery, whereas patient 2 was discharged on the same day as the surgery. Lessons: TEP hernia repair using abdominal PNB anesthesia seemed to be a safe and feasible technique without causing any additional complications. However, the use of abdominal PNB anesthesia alone for TEP hernia repair as an alternative to general anesthesia requires further investigation using a larger cohort.
KW - Abdominal peripheral nerve block
KW - Inguinal canal block
KW - Inguinal hernia
KW - Rectus sheath block
KW - Totally extraperitoneal
KW - Transversus abdominis plane block
UR - http://www.scopus.com/inward/record.url?scp=85049240446&partnerID=8YFLogxK
U2 - 10.1097/MD.0000000000010964
DO - 10.1097/MD.0000000000010964
M3 - Article
C2 - 29901585
AN - SCOPUS:85049240446
SN - 0025-7974
VL - 97
JO - Medicine (United States)
JF - Medicine (United States)
IS - 24
M1 - e10964
ER -