Name of the Procedure:

Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias
Common Name(s): Hernia repair anesthesia, Abdominal hernia surgery anesthesia

Summary

Anesthesia for hernia repairs in the lower abdomen involves administering medication to prevent pain during surgery for ventral and incisional hernias. This allows the patient to undergo the procedure comfortably and safely, either while being unconscious (general anesthesia) or numbed below the waist (regional anesthesia).

Purpose

The procedure is designed to:

• Prevent pain and discomfort during hernia repair surgery.
• Ensure patient immobility and relaxation, which aids in a smooth and efficient operation.

Indications

This anesthesia procedure is indicated for:

• Patients needing surgical repair of a ventral hernia (hernia through the abdominal wall) or an incisional hernia (hernia at the site of a previous surgical incision).
• Individuals experiencing symptoms like pain, bulging, or discomfort in the abdomen.

Preparation

Before the procedure:

• Patients are usually required to fast for at least 6-8 hours.
• Medication adjustments may be necessary, particularly for blood thinners.
• Pre-operative assessments may include blood tests, an EKG, or imaging studies to evaluate the hernia.

Procedure Description

1. Pre-op: The anesthesiologist conducts a medical evaluation and explains the anesthesia plan.
2. Administration: Depending on the type of anesthesia:
   • General Anesthesia: Delivered via IV or inhalation, putting the patient completely asleep.
   • Regional Anesthesia (e.g., spinal or epidural): Administered via injection near the spinal cord to numb the lower body.
3. Monitoring: Vital signs are continuously monitored.
4. Maintenance: Anesthetic agents are maintained throughout the surgery, adjusted as needed by the anesthesiologist.
5. Recovery: Anesthesia is gradually withdrawn, and the patient is monitored as they wake up.

Duration

The anesthesia administration itself takes about 15-30 minutes, while the entire hernia repair procedure typically takes 1-2 hours.

Setting

This procedure is performed in a hospital's operating room or a surgical center equipped for advanced medical care.

Personnel

Key personnel include:

• Anesthesiologist or nurse anesthetist
• Surgeon
• Operating room nurses
• Surgical technician

Risks and Complications

Potential risks include:

• Common: Nausea, vomiting, sore throat (after general anesthesia), headache (after spinal anesthesia).
• Rare: Allergic reactions, breathing difficulties, nerve damage, prolonged numbness or weakness, infection, or bleeding.

Benefits

• Pain-free surgery experience.
• Improved surgical outcome through relaxed muscles and immobility.
• Rapid initiation of recovery post-procedure.

Recovery

Post-procedure care includes:

• Monitoring in the recovery room until the effects of anesthesia wear off.
• Instructions on wound care, activity restrictions, and pain management.
• Follow-up appointments to ensure proper healing.

Alternatives

Alternative treatments may involve:

• Non-surgical methods like watchful waiting or wearing a supportive truss.
• Other types of anesthesia based on patient preference and medical condition.
  • Pros: Non-invasive options have minimal risk.
  • Cons: They may not address the underlying cause effectively.

Patient Experience

During the procedure, patients will feel no pain due to the anesthesia. Post-operatively, they might experience mild discomfort or tiredness, which can be managed with pain relievers and rest. Comfort measures include providing a calm environment and offering supportive care throughout recovery.