Cryoanalgesia for pain after herniorrhaphy

Abstract

SummaryThe e[/ect of,free:ing the ilioinguinal nerve on postoperative pain relief was examined in a double blind study in 36 patients undergoing herniorrhaphv. randomly allocared into two groups. Patients in the experimental group had their ilioinguinal nerves .fro:en during .surgery and were compared with the patients in rhe control group who did nor huve cryoanalgesia. Pain relief was assessed overa 48-hour period in three ways, namely the linear analogue pain scale, peak espiratory ~7 o w rates and the amounr of analgesic drugs required by patients in the two groups. We conclude that cryoanalgesia of rhe ilioinguinal nerve alone does not produce significant early post herniorrhaphy pain relief.

Anesthesiology and Pain Management

“…This has been demonstrated in patients with hip replacement and abdominal operation by Pflug et al (32) and more recently 85 by Yeager and associates (33) in poor risk patients. Current evidence suggests that if pain and stress and the consequent neuroendocrine response playa major role in the development of pulmonary gastrointestinal and genitourinary dysfunction and frequently complication as well as impairment of muscle metabolism and the development of thromboembolism.…”

“…A related and still relatively new and exciting development that has been spearheaded by anesthesiologists has been acute pain services, the concept first described by my colleague, Brain Ready (85). these services provide patients with acute postoperative and post-traumatic pain with effective pain relief on a 24-hour basis, using epidural opioid analgesia (EOA) or intrathecal opioid analgesia (lOA), patient-controlled analgesia (peA), and regional analgesia with local local anesthetic used alone or in combination with EOA.…”

“…Celiac plexus block has been performed by a posterior approach and anterior approach and under direct vision during a laparotomy (76-78) Several methods of performing these blocks have been described. Some authors advise the radiographic placement of Teflon cannula, which is used initially for a diagnostic block and subsequently for the destructive block (67,85). Some authors strongly advocate radiographic location of the needle tip to ensure accurate injection (67,79,(82)(83)(84) and this author agrees (1).…”

Wound infiltration with plain bupivacaine as compared with bupivacaine fentanyl mixture for postoperative pain relief after abdominal surgery

“…TENS, ALTENS, conventional acupuncture[6] relaxation technique, and cryoanalgesics have also shown inconsistent results. [7] However, there has been renewed interest in local anesthetic wound instillation for postoperative pain control. Eriksson studied the in vivo effects of lidocaine on leucocyte function in the surgical wound.…”

Cryoanalgesic ablation for the treatment of chronic postherniorrhaphy neuropathic pain

“…Cryoanalgesia has been applied to the ileoinguinal nerve and dissected tissues at the time of inguinal herniorrhaphy without significant impact on the level of acute postoperative pain or prevention of chronic postherniorrhaphy pain [6,12]. We have not investigated the use of preemptive cryoanalgesia applied at the time of surgery because it is our belief that not all patients would benefit from the persistent inguinal anesthesia that results, and because acute postoperative pain is so adequately addressed by NSAIDs, COX-2 inhibitors, and narcotic analgesics.…”