Inguinal Hernia Repair with Mesh

Anesthesia Implications

Position: Supine, arms extended
Time: 1-2 hours (average)
Blood Loss: Very Low (5-10 ml)
Post-op Pain: Minimal (1-3)
Maintenance Paralytic: Ask surgeon

Anesthetic Approaches

  • MAC, Propofol Drip
  • GLMA
  • GETT
The Anesthesia

Very quick procedure depending on the surgeon. Use an approach that allows the patient to wake up quickly.

Smooth emergence – avoid bucking/coughing.

The Pathophysiology

A hernia is any protrusion/bulge out of the tissues that normally contain it. The abdominal wall contains multiple tissues including muscle and connective tissue which spans from the xiphoid process to the pubic symphasis and iliac crest.

Abdominal hernias are primarily caused by a weakening of the tissues contain the abdominal viscera.

Abdominal hernias may be classified as ventral, groin (inguinal and femoral subclassifications), pelvic, and flank. Approximately 5 million American’s have abdominal hernias. The majority are groin hernias.

Further classification may be used in conjunction with the etiology: congenital (such as gastroschisis or omphalocele) and acquired (weakening or disruption of the wall tissues).

Far more common in men (10x) than women.

References: Hines. Stoelting’s anesthesia and co-existing disease. 7th edition. 2018.