OC-004 LIGNOCAINE INFILTRATION FOR LICHTENSTEIN REPAIR UNDER LOCAL ANESTHESIA: TECHNIQUE AND RESULTS

Abstract Background Lichtenstein inguinal hernia repair (LIHR) is the most commonly performed operation for inguinal hernia, even in developed nations. The European Hernia Society (EHS) guidelines recommend that local anesthesia (LA) should be considered an option in all patients undergoing LIHR. However, most patients still undergo this repair under general anesthesia (GA) or spinal anesthesia (SA). Even in a low resource area like North Ghana, only 37% patients had LIHR under LA. Specialty hernia clinics perform a majority of inguinal hernia repairs under LA. They have standardized their technique of administration of LA and the technique described by Amid et al. is simple, easily learnt, and works well in the hands of an average surgeon as well as a surgical trainee. However, not all surgeons are comfortable in performing this operation under LA. One possible reason for this is that the surgeon prefers a relaxed operating feld and he has heard stories of bad experiences with LA because of non-optimal technique of LA with unacceptable intensity of pain during LA. Aim To present a short video demonstrating the technique of infiltration of lignocaine for Lichtenstein repair under LA. Materials and methods Video. Results In our series of 30 patients, median intra-operative pain VAS was 2.5(0,5). 30% patients reported a VAS>3 during operation. All patients successfully underwent operation using LA. Conclusion LA should be strongly considered for all patients with unilateral inguinal hernia undergoing open repair.