Outcomes of giant inguinoscrotal hernia repair with local lidocaine anesthesia

OBJECTIVE: To report outcomes of giant inguinoscrotal hernia repair using local lidocaine anesthesia in a resource-poor subregion.

METHODS: Patients treated with giant inguinoscrotal hernia at 2 private healthcare facilities in Nigeria were studied between January 2004 and December 2008.

RESULTS: A total of 134 patients aged between 13 and 70 (mean 32 ± 7.6) years, accounting for 51.3% adults treated for groin hernias, had open repair of 136 giant inguinoscrotal hernia using lidocaine. Average duration of symptoms (14.5 years) before presentation was influenced by lack of awareness in 82 (61.2%) and financial constraint in 34 (25.4%). The procedure was well tolerated as local lidocaine alone was used in 124 (92.5%), but 10 (7.5%) patients who had incarceration-required sedation using diazepam and/or ketamine with no conversion to spinal or general anesthesia. Postoperative courses were uneventful as prophylactic antibiotics and paracetamol gave good results, those without incarceration ambulated and commenced oral intake after 24 hours. All were admitted between 48-72 hours before discharge and returned to normal vocation after a month. Scrotal hematoma(13.5%) and wound infection (4.5%) resolved within a month with no recurrence so far on 1-5 years follow-up.

CONCLUSION: Giant inguinoscrotal hernia repair using local lidocaine was well tolerated and obtained comparable results to spinal or general anesthesia in resource-poor regions.