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Introduction: Inguinal bladder herniation (IBH) is a rare disease that presents with inguinal and scrotal protrusion as well as urinary symptoms, and if not diagnosed before surgery, it may cause complications such as bladder injury during surgery. In this study, it was reported a 72-year-old man with right inguinal bulging and urinary obstruction symptoms. In the ultrasonography, two stones in the left kidney and a larger than normal prostate volume was reported. In the CT scan, inguinal bladder herniation with extension to the scrotum was seen, which contained a 13 mm stone. Cystography also confirmed it. Transvesical prostatectomy was performed. The stone was removed. Then, the herniated bladder was reduced through an incision on the right inguinal canal and the mesh was inserted.

Background and Aim: Controversy exists over the preferred surgical method for inguinal hernia repair between the open and laparoscopic methods. This clinical trial was performed to compare the rate of early complications and recurrence rates of inguinal hernia between laparoscopic (TAPP) and open methods (Lichtenstein). Material and Methods: In this clinical trial, 84 patients who were candidates for elective inguinal hernia repair at Imam Hossain Hospital were randomly divided into two groups: TAPP and Lichtenstein groups. Spinal anesthesia was used for both groups. Patients were followed for short-term complications (e.g. infection, seroma, hematoma, postoperative pain), hospitalization stays, and recurrence within the first year. Data were analyzed using SPSS software (version 16). Results: There were no significant differences between the two groups in terms of age and gender. Unfortunately, in the TAPP group, 23 patients (54.8%) received general anesthesia due to lack of co-operation, excessive abdominal wall stiffness, and failure of spinal anesthesia. We found shorter hospitalization stay (P

Background and Objective: Bladder hernias occur in 1% to 4% of cases in the inguinal area. The hernial sac may contain any part of the bladder, such as the bladder diverticulum, all or part of the bladder and ureter. Most of these hernias are diagnosed during surgery. Delay in diagnosis can lead to serious complications and even death. The aim of this case report is to introduce a patient with a rare hernia of the bladder diverticulum in the inguinal region. Case Report: The patient is a 58-year-old man who referred to Namazi Hospital in Shiraz with a bulge in the right inguinal region with symptoms of incarcerated hernia. The patient complained of pain and swelling in the right inguinal region and did not show any signs or symptoms of urinary tract involvement. During laparotomy, the mass was found to be connected to the bladder and the patient underwent inguinal hernia repair. The patient was discharged from the hospital one day after the operation without any problems. No complications were reported in follow-up two months after surgery. Conclusion: According to our report, hernia of the urinary bladder diverticulum in the inguinal region may be asymptomatic. Therefore, accurate reporting of the patient's history and previous problems and diseases is required for careful surgical planning to prevent severe complications, including bladder injury in these people.

Objectives: The effects of anesthesia techniques and anesthetics on different systems and organs of the body, especially the immune system, in older patients undergoing surgery, have always been of interest to researchers. This study aims to compare the effects of general anesthesia with isoflurane and spinal anesthesia with lidocaine on oxidative and antioxidant parameters in older patients with inguinal hernia surgery. Methods & Materials: This is a double-blinded randomized clinical trial with parallel design conducted on 70 older patients referred to the surgery department of hospitals in Tehran, Iran during 2018-2019. They were randomly divided into two groups of 35; the first group received general anesthesia with isoflurane and the second group received spinal anesthesia with lidocaine. Blood sampling was performed in two stages; one day before and one day after surgery. Advanced Glycation End Products (AGEs), Advanced Oxidation Protein Products (AOPP), Malondialdehyde (MDA), oxidized Low-Density Lipoprotein (LDL), Ferric-Reducing Ability of Plasma (FRAP), glutathione peroxidase, superoxide dismutase and catalase levels were measured before and after anesthesia using standard methods. Collected data were analyzed in SPSS v.22 software. Results: The Mean±SD age of patients in the lidocaine group was 69.94±8.31 years and in the isoflurane as 70.23±4.98 (P>0.81). In the isoflurane group, there was a significant difference between pre- and postoperative levels of AOPP, MDA, oxidized LDL, FRAP, catalase, glutathione peroxidase and superoxide dismutase. In the lidocaine group, this difference was significant in MDA, oxidized LDL, catalase and superoxide dismutase. Conclusion: Given the positive effects of isoflurane on oxidative and antioxidant parameters in older patients with inguinal hernia surgery, it is recommended that this anesthetic be considered in the selection of anesthesia methods and drugs for this group of older patients.

Background: The aim of this study was to investigate the effect of subcutaneous injection of metoclopramide, pethidine, and ketamine on postoperative pain after inguinal hernia repair under general anesthesia compared to control group. Methods: In this clinical trial study, 104 patients were selected and randomly divided into four groups of 26 patients. The patients received subcutaneous injection of each drug at the incision site. In the first group, 0.5 mg/kg ketamine, in the second group, 0.75 mg/kg pethidine, in the third group, 0.1 mg/kg metoclopramide, and in the control group, normal saline were administered. We evaluated the pain intensity [by visual analog scale (VAS)], hemodynamic parameters, extubation and recovery time, drug complications, total rescue analgesic consumption, time to first analgesic request, and satisfaction score for the initial 24 hours after entrance to recovery. Findings: The mean of VAS at the most of measuring times (P < 0.050) and the mean of total rescue analgesic consumption (P = 0.007) were significantly lower in the ketamine and pethidine groups compared to metoclopramide and control groups. The satisfaction score for postoperative analgesia in pethidine group was significantly higher than the other groups (P < 0.001). Conclusion: Pethidine and ketamine have equal effects on postoperative pain; but the patients were more satisfied with pethidine. The effect of metoclopramide on the postoperative pain was lower than the other two drugs; moreover, its effect was equal to the placebo and was associated with more adverse reactions.

Background and Objective: Appropriate analgesia after surgery helps patients feel more comfortable and increase the mobility of them. The purpose of this study was to compare the effect of subcutaneous injection of Ketamine and Lidocaine in reducing postoperative pain in patients undergoing elective inguinal hernia surgery under general anesthesia. Methods: This double blinded, randomized clinical trial study was done on 60 patients undergoing elective inguinal hernia under general anesthesia. Subjects were randomly assigned into three groups including control, Ketamine and Lidocaine groups. Subjects in Ketamine group were received infiltration of subcutaneous Ketamine 0.5 mg/kg/bw after closure of surgical incision. Subjects in Lidocaine group were received infiltration of subcutaneous Lidocaine 1 mg/kg/bw at the time of wound suturing. Subjects in control group did not receive Ketamine and Lidocaine. The visual analogue scale (VAS) of pain and vital signs were continuously assessed. If VAS≥3, 100 mg diclofenac suppository was administered and if there were no response, 30 mg intravenous pethidine was also administered. The complications, including hallucination, nystagmus, nausea, vomiting and drowsiness in patients were also recorded. Results: The mean VAS at 1, 2 hours after surgery were significantly lower in the Ketamine and Lidocaine group in compared to control group (P

Background: Surgery of inguinal hernia has complications such as postoperative nausea and vomiting. Regarding the unpleasant side effects of anti-nausea and anti-vomiting drugs, as well as prolonged hospital stay, this study aimed to evaluate the effect of acupressure PC6 and REN 12 points on nausea intensity of patients undergoing inguinal hernia surgery. Methods: This was a double-blind randomized clinical trial study performed on 60 patients undergoing inguinal hernia repair in two groups of intervention. After the surgery and full patient consciousness, acupressure was applied on PC6 and REN 12 points separately in each group for 5 minutes; 2, 4, and 6 hours later, acupressure was repeated on those points. Two hours after each acupressure, severity of nausea were determined using a visual analog scale (VAS). Data were analyzed using t, chi-square, and Fisher’s tests via SPSS software. Findings: In PC6 intervention group, recorded scores were as 16.17 ± 0.63, 8.83 ± 0.49, 2.97 ± 0.23, 0.50 ± 0.11, and 0.00 ± 0.00in without, mild, moderate, sever, and very sever nausea, respectively, whereas in REN12 intervention group, these scores were as 18.70 ± 0.80, 14.53 ± 0.64, 6.67 ± 0.42, 2.47 ± 0.37, and 0.50 ± 0.47, respectively. Conclusion: Generally, acupressure particularly on the PC6 point reduces severity of nausea in patients after inguinal hernia surgery; these results are better compared to the REN12 point.

Background and Objective: Appropriate analgesia after surgery helps patients feel more comfortable and increase the mobility of them. The purpose of this study was to compare the effect of subcutaneous injection of Ketamine and Lidocaine in reducing postoperative pain in patients undergoing elective inguinal hernia surgery under general anesthesia. Methods: This double blinded, randomized clinical trial study was done on 60 patients undergoing elective inguinal hernia under general anesthesia. Subjects were randomly assigned into three groups including control, Ketamine and Lidocaine groups. Subjects in Ketamine group were received infiltration of subcutaneous Ketamine 0.5 mg/kg/bw after closure of surgical incision. Subjects in Lidocaine group were received infiltration of subcutaneous Lidocaine 1 mg/kg/bw at the time of wound suturing. Subjects in control group did not receive Ketamine and Lidocaine. The visual analogue scale (VAS) of pain and vital signs were continuously assessed. If VAS≥3, 100 mg diclofenac suppository was administered and if there were no response, 30 mg intravenous pethidine was also administered. The complications, including hallucination, nystagmus, nausea, vomiting and drowsiness in patients were also recorded. Results: The mean VAS at 1, 2 hours after surgery were significantly lower in the Ketamine and Lidocaine group in compared to control group (P<0.05). No significant adverse effect was observed in the Ketamine group. Conclusion: For reduction of pain, administration of subcutaneous Ketamine is recommended due to no adverse effect and anti analgesic effect of Ketamine is similar to Lidocaine. [ABSTRACT FROM AUTHOR]

Background: Inguinal hernia is a common surgical problem which increases with aging especially in men. A common method for treatment is surgical repair using prosthesis, Lichtenstein technique. One frequent complication after inguinal herniorrhaphy is soft tissues seroma. There are several methods to prevent or to drain seroma. Some surgeons suggest the insertion of closed suction drainage system but others disagree. Methods: In this clinical trial study, 42 patients who are candidate for hernia repairing (Lichtenstein technique), referred to Amir Al-Momenin Hospital in Semnan, Iran, from 2011 to 2012, were randomly divided into two groups. So that, the list of eligible patients in the study, were numbered, and then using the patients' code, patients, who assigned an odd number in the registration list, were allocated to group 1, the remainder were placed in group two. The two first numbers in registration list (1 or 2), were randomly assigned to groups. Group 1 underwent hernia surgery without closed suction drainage and the second group underwent hernia surgery with closed suction drainage. The patients were evaluated for seroma, hematoma or wound infection after 24 hours, during days 4 to 7 and days 10 to 15 following surgery. Results: No adverse event including hematoma, seroma or wound infection occurred in either group with or without closed suction drainage in the first 10 days after surgery. Only one patient carried wound infection during days 10 to 15 following operation who was in the group with closed drainage (P=1.00). Conclusion: In this study, Seroma and hematoma was not observed in patients with and without closed suction drainage. To avoid drains' complications, indiscriminate use of antibiotics, prolonged hospital stay, we do not recommend the use of drains in this type of surgery.

BACKGROUND AND OBJECTIVE: Inguinal hernia repair is one of the most prevalent procedures in general surgery. Several methods have been introduced for inguinal hernia repair that focus on the reduction of complications of surgery and lowering the recurrence of the hernia. However, controversies remain among surgeons about the preferred treatment method. The aim of this study was to compare the outcomes of repairing inguinal hernia with mesh and non-mesh methods.METHODS: All patients aged 18 years old and over that admitted for inguinal hernioraphy in Shahid Behesti hospital in Babol during March to September 2010 included in the study. Demographic data, characteristics of hernia, duration of returning to daily activities and the type of repair of each patient entered in the checklist. All patients followed up for one year in case of any complication and recurrence of hernia. Recurrence of hernia due to ascites or due to any increase in abdominal pressure and missed patients during the follow up period was excluded from the study.FINDINGS: Among all 132 cases 129 patients were male and 3 patients were female and the mean age of the patients was 53.66±16.89 years. Forty five (34.1%) patients underwent hernioraphy with mesh and 87 (65.9%) patients without mesh. The mean time for patients to return to daily activities was 25.4±4.7 days in the mesh group and 28.53±7.86 days in the non-mesh group (p=0.048). Rate of recurrence of hernia during the follow up period was 8 cases (6.1%) that 6 cases had been repaired with non-mesh method and 2 cases were repaired with mesh method (p>0.05).CONCLUSION: Simple inguinal hernias seem to be repaired better with mesh method than non-mesh method.

Background: The aim of this study was to compare operating time and short-term complications of laparoscopic transabdominal preperitoneal hernia repair during reperitonealization in Trendelenburg versus reverse-Trendelenburg positions.Methods : Thirty-nine patients with inguinal hernia were enrolled in this clinical trial. Study was done in Milad and Rasoul Akram hospitals in Tehran, Iran, during 2008-2010. The patients neither were pregnant nor did they have any signs of peritonitis, strangulation, perforation or infection. Moreover, they had a Body Mass Index (BMI) below 35 kg/m2 and were physically fit for general anesthesia. The participants were divided into two groups by block randomization. The first (20) and the second (19) groups of patients underwent laparoscopic herniorrhaphy in Trendelenburg and reverse-Trendelenburg positions. Respectively all the operations were performed by one surgeon. The patients were visited one day and one week after the surgery.Results : Most frequent complications were rupture in peritoneal repair in 9 patients (23%), skin site bleeding in one patient (2.6%), and peritoneal tension in 33 patients (84.6%) patients. Duration of surgery and peritoneal repair took a significantly longer time in Trendelenburg versus the reverse-Trendelenburg position. There were no differences in duration for returning to work or resumption of daily activities between the two groups. Pain in the first day following surgery was statistically more severe in the Trendelenburg group.Conclusion: This study demonstrated that reverse-Trendelenburg position took less time for herniorrhaphy and peritoneal repair than Trendelenburg position, although the complications were the same.

Introduction: ''Lichtenstein'' tension-free mesh repair is the most common surgical techniques used for inguinal hernia repair." Read-Rives" method is tension-free, too, but here prosthesis is placed just over the peritoneum, and there is no weak area. The aim of this study was to compare the results of "Read-Rives" and Lichtenstein method in the hernioplasty. Methods and Materials: In this prospective randomized clinical trial 126 patients who had unilateral inguinal hernia were examined: 64 patients operated with Lichtenstein and 62 patients operated with Rives method. They evaluated for early post-operative complications, duration of surgery and hospital stay, return to normal activity, and then they followed for recurrence of hernia. Results: Postoperative pain was significantly lower and the return to normal activity was shorter in Rives group. Duration of surgery and hospital stay and recurrence rate was equal, lower postoperative wound infection was found within Rives method. Conclusions: Although the ''Read-Rives'' method is not technically as simple as ''Lichtenstein'' method, but this procedure is easy to learn, so it is recommended because of its better final outcome in comparison with Lichtenstein repair.

"n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: The inguinal hernia is a common disorder in general surgery. Different methods have been described for repair of these hernias. In modern methods, synthetic mesh is used to cover the wall defect and the most known method is Lichtenstein surgical repair. The laparoscopic totally extra peritoneal procedure (TEP) is a newer technique of repairing hernia. The aim of this study is to compare the outcomes of totally extraperitoneal laparoscopic inguinal hernia repair versus Lichtenstein open repair in patients with inguinal hernia."n"nMethods: Among 50 patients, 25 cases underwent Lichtenstein procedure and 25 patients underwent TEP technique for repairing primary unilateral inguinal hernia. Findings during the operation have been recorded and the 12-months follow-up of patients in different views was performed through a questionnaire and then the results were compared."n"nResults: The operation duration, the rate of complications and frequency of recurrence were similar in two groups; but the hospital stay, postoperative pain, chronic groin pain and the required time to return to normal activity were significantly lower in patients who underwent the TEP method compared to the patients who underwent the Lichtenstein technique (p

"nBackground: Epithelioid sarcoma is a malignant soft tissue tumor of uncertain histogenesis, categorized as a morphologically distinct neoplasm that characteristically affects the distal parts of the extremities in young adults. In fact, epithelioid sarcoma is the most common soft tissue sarcoma in the hand and wrist. "nCase report: This 32 year-old male presented with an inguinal swelling, for which he underwent surgery with the initial intent of inguinal hernia repair. With this uncommon manifestation and site, among the differential diagnosis were abscess and GI malignancies. However, after a supplementary evaluation that included biopsy of the ulcer margin, the diagnosis focused on undifferentiated high-grade epithelial tumor, highly suggestive of epithelioid sarcoma. Immunohistochemical studies revealed CD34 and cytokeratin positivity, which confirmed this diagnosis. "nConclusion: Due to the malignant nature, invasive behavior and high recurrence rate of this tumor, as well as its unknown response to chemotherapy and radiation, extensive resection and hepatectomy are recommended for treatment.

Inguinal hernia is common in midlle age and elderly. It is in two form of direct and indirect. Often the hernia sac consists of omentum and or intestinal segmants, but bladder hernia is very rare. In present patient massive inguinal hernia and urinary retention were associated with ipsilateral nonvisulization and nonfuncting kidney that showed the disease is chronic in nature. The diagnosis is confirm by ultrasonography and retrograde cystography. In cystography, contrast maternal is show in scrotal cavity and commnication of it with bladder. In our case, the diagnosis is made preoperatively with ultrasonograpy and cystography. The patient able to void post-oprative day and scrotal enlargment is compelely reduce. In conclusion it is advised that in patients older than 50 years who have massive inguinoscrotal herina and prostatism cystography to be done mandatory and also preoperative diagnosis is to be made to prevente the injury of bladder and ureter in operating time.

Background: Familiarity with different methods and medications in anesthesia and producing sufficient depth of anesthesia are very important in anesthesia practice. Due to the central analgesic and sedative effect of lidocaine in the presence of the sufficient blood level, it can be used for general anesthesia. This study was carried out to compare the effect of halothane with lidocaine infusion on BIS during maintenance of anesthesia. Materials and Methods: In this randomized double-blind controlled clinical trial, 66 patients scheduled for elective inguinal herniorrahaphy were randomized into two equal groups. For maintenance, one group received halothane (1%) with O2-N2O and another group received lidocaine infusion (100 &mug/kg/min). BIS was checked every 5 minutes for half an hour. Statistical analysis of data was done by Chi-square and T-test through SPSS software. P-values less than 0.05 were considered meaningful. Results: Mean of BIS was 65.72 in the lidocaine group and 56.7 in the halothane group during the first 30 minutes. There was a significant statistical difference between the two groups (p<0.05). Conclusion: Mean of BIS in lidocaine group was higher than that in the halothane group. If this indicates the presence of a light level of anesthesia, increasing the dose of hypnotics and opioids leads to an increase in the depth of anesthesia. However, since there is not any device for monitoring the effect of opioids on the central nervous system and the level of anesthesia, simultaneous monitoring of BIS and hemodynamic parameters seems to be a more reasonable idea. [ABSTRACT FROM AUTHOR]

Background: According to increasing use of ultrasound in the diagnosis of inguinal herniation, this study was designed to evaluate the cross-sectional area of the inguinal canal in patients with inguinal herniation and its increase with Valsalva maneuver. We also compared the obtained values with those of normal population. Methods: a cross-sectional study, 52 normal persons and 35 cases with inguinal hernia were assessed. The cross-sectional area of the inguinal canal was measured in all subjects and data was analyzed using Student's t-test and Pearson's correlation tests in SPSS. Receiver operator characteristic (ROC) curves were traced to define cut-off points. Findings: Valsalva maneuver caused significantly greater increase in the cross-sectional area of the inguinal canal among patients than in the normal group. The cut-off point of the cross-sectional area of inguinal canal was 63.5 mm2 in neutral state and 72.5 mm2 with Valsalva maneuver (increase rate: 34 mm2). In the absence of Valsalva maneuver, a cross-sectional area of the inguinal canal of greater than 63.5 mm2 is predictive of inguinal hernia (with 91% sensitivity and 98% specificity). Otherwise, values greater than 72.5 mm2 will be predictive of inguinal hernia (with 100% sensitivity and 98% specificity). Inguinal hernia will also be suspected if Valsalva maneuver increases the cross-sectional area of the inguinal canal by more than 34 mm2 (with 91% sensitivity and 100% specificity). Conclusion: The following diagnostic criteria are suggested for diagnosis of inguinal hernia through ultrasound examination: the presence of bowel loop within the inguinal canal, a cross-sectional area of the inguinal canal > 63.5 mm2 without Valsalva maneuver and > 72.5 mm2 with Valsalva maneuver, an increase of > 34 mm2 in the cross-sectional area of the inguinal canal with Valsalva maneuver, and a > 0.5 cm movement of the spermatic cord with Valsalva maneuver. [ABSTRACT FROM AUTHOR]

Background: There are many controversies about relationship between hernias and connective tissue disorders in children. The aim of this study was to determine the relationship of benign joint hypermobility syndrome (BHJS) with inguinal hernias in children. Methods: This descriptive analytical study involved children of 2-12 years old who were diagnosed with inguinal hernia during 2009-11. Subjects were admitted to pediatric or pediatric surgery wards of hospital affiliated with Isfahan University of Medical Sciences (Iran). Overall, 200 children in two groups of patients with inguinal hernias and controls were included. Beighton score was used for diagnosis of BHJS in the admitted children and the control group. For evaluation of collected data and the relationship of diseases, we used SPSS18 and chi-square test. Findings: The mean Beighton score was 6.2 ± 2.0 in the case and 2.7 ± 2.2 in the control group, i.e. children with inguinal hernias had significantly higher Beighton scores (P < 0.001). Conclusion: Based on this study, BHJS is prevalent in children with inguinal hernias. Therefore, in every patient with inguinal hernias, the presence of concomitant BHJS should also be considered. [ABSTRACT FROM AUTHOR]

Background: Inguinoscrotal hernia of the bladder is a rare clinical entity. Bladder herniation is commonly small, clinically silent, and incidentally detected during elective hernioplasty. Bladder resection is indicated if tumor or necrosis is detected. Few cases of bladder herniation containing neoplasia have been reported and usually discovered intraoperatively. Case Report: We herein reported our experience with 3 inguinoscrotal bladder hernias treated with partial cystectomy and routine herniorrhaphy. One patient had high grade superficial transitional cell carcinoma and one had bladder stone. Conclusion: Despite the 3 layers of the bladder being normal, it seems reasonable to manage cases of massive inguinoscrotal bladder hernia accompanied by stone or tumor like acquired diverticular disease by diverticular excision (partial cystectomy). [ABSTRACT FROM AUTHOR]

Background and purpose: Surgical site infections are infections of the tissues, organs, or spaces exposed by surgeons during performance of an invasive procedure, and the development of SSIs is related to the degree of microbial contamination of wound during surgery, duration of the procedure, and host factors. Inguinal hernioplasty is one of the most common surgical operations. The use of prophylactic antibiotic in Lichtenstein hernioplasty is controversial. Hence this study done to evaluate the prophylactic antibiotic effect in reducing the post operative wound infection in Lichtenstein hernioplasty. Materials and methods: This is an interventional double-blind randomized trial on 282 patients under going, Unilateral primary elective inguinal hernioplasty with Lichtenstein method. Using polypropylene mesh. They were randomized to receive 1gr/1v cephalotin (keflin) or equal volume of placebo 30min before incision. Patients were evaluated 1week, 2weeks and 12weeks after surgery by an independent surgeon or resident. Wound infection was defined according to the criteria of centers for Disease control and recorded. Results were assessed using chi-square and t-test as appropriate. Results: We included 282 patients in this study between March 2010 and october 2011. The total number of wound infection was 13 (4.7%), 4(2.8%) in antibiotic group and 9(6.4%) in placebo group (p= 0.29). There was 1 deep infection only in placebo group. Statistical analysis showed no significant difference in two groups. Conclusion: The results show that, in Lichtenstein hernioplasty, routine use of prophylactic antibiotic is not indicated, as it does not significantly reduce the post operative surgical site infection rates. [ABSTRACT FROM AUTHOR]

Background: Non-steroidal anti-inflammatory drugs (NSADs) and opioids are frequently administered to relieve postoperative pain. Uncontrolled postoperative pain may produce a range of detrimental acute and chronic health consequences and increase mortality and morbidity. Practically, the analgesic efficacy of opioids is typically limited by the development of tolerance to them or by opioid-related sideeffects such as nausea, vomiting, sedation or respiratory depression. This study aims to assess the effects of suppository diclofenac on post-herniorrhaphy pain management. Methods: In this prospective double-blind clinical trial, 60 patients who were candidate for the surgical repair of inguinal hernia were divided into two groups. Patients in group A received 100 mg of suppository diclofenac and patients in group B 50 mg of pethidine after the induction of anesthesia and before surgical incision. Postoperative pain assessment was done by an unbiased observer on the arrival of patients in the recovery room, using a 10-cm visual analogue scale (VAS) at 2-hour intervals for 6 hours. Results: Pain relief was similar in the two groups (P=0.3). Patients in group B required more analgesia two hours post-operatively (P=0.03), while patients in group A had more favorable results regarding pain control (P<0.05). Statistically, there was no difference between the two groups at other intervals. The occurrence of nausea and vomiting was similar in both groups. No respiratory depression was observed in the patients. Conclusion: Preventive analgesia with 100 mg of suppository diclofenac after anesthesia induction for herniorrhaphy produced effective postoperative analgesia with minimum side-effects. [ABSTRACT FROM AUTHOR]

Background: Inguinal herniotomy is the most common operation in pediatric surgery. The aim of this study was comparison of two methods of herniotomy with and without opening of external oblique muscle fascia. Methods: 49 patients with inguinal hernia was surveyed in two groups. 25 PT was operated without opening and 24 PT with opening of facia from 2006 lun -2007 lun. Data of age sex post operative complications (score of pain and firmness of wound) Time of surgery and anesthesia were analyzed with T -Test and X2 and P < 0.05 was meaningful. Finding: No meaningful different was about age and sex between the two groups but score of post operative pain and firmness, mean of operative and anesthetic times were loss significantly in without opening fascia group (P = 0.000) . No recurrence of hernia was observed as follow as one year. Conclusion: Inguinal herniotomy without opening of fascia was effective as another procedure with more less complications and duration of operation and anesthesia. [ABSTRACT FROM AUTHOR]