title: Tumescent local anesthesia in inguinal herniorrhaphy with a PROLENE hernia system: original technique and results.
abstract: BACKGROUND
  Local anesthesia (LA) for inguinal herniorrhaphy has many advantages, but its practical use is rare. We presented a new method, tumescent local anesthesia (TLA), for inguinal herniorrhaphy with a PROLENE hernia system (PHS).
  
  
  METHODS
  Sixty-six patients underwent inguinal herniorrhaphy with PHS under TLA of .05% lidocaine and .0125% bupivacaine diluted in normal saline with epinephrine (1:1,000,000) and 10 mEq/L of sodium bicarbonate.
  
  
  RESULTS
  No patients required conversion to general anesthesia. The mean dose of lidocaine was 188.1 +/- 40.5 mg, and the mean duration of surgery was 73.4 +/- 23.8 minutes. Intraoperative sedation was required in 1.5% of patients, and painkillers in the early postoperative period were required in 13.6%. No recurrence was observed up to 2 years after surgery.
  
  
  CONCLUSIONS
  Our results suggest that the TLA technique is safe and applicable in inguinal herniorrhaphy and may have some beneficial effects regarding intra- and postoperative analgesia.
authors.affiliation: Department of Surgery, Shinko Hospital, Kobe, Japan. narinari@kuhp-u.ac.jp
authors.forename: Masato
authors.initials: M
authors.lastname: Narita
authors.forename: Shigeru
authors.initials: S
authors.lastname: Sakano
authors.forename: Shogo
authors.initials: S
authors.lastname: Okamoto
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yamamoto
mesh_terms: D000779:Anesthetics, Local / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002045:Bupivacaine / Q000627:therapeutic use*; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010149:Postoperative Pain / Q000517:prevention & control; D011126:Polypropylenes; D013526:Surgical Mesh
chemical_list: D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D011126:Polypropylenes; D008012:Lidocaine; D002045:Bupivacaine