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M O N T H 2 0 1 4 | S U P P L E M E N T T O O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E
The best opportunity to
control a patient's post-op
discomfort comes not
after they begin to feel
pain, but before it is trig-
gered. This is where pre-
emptive pain manage-
ment comes in.
Anesthesia providers who
administer IV ketorolac or acetaminophen before surgery starts can in 20 or 30
minutes' time ensure a good response to block the patient's pain pathways
before they've been activated. This works alongside the anesthesia and any
abdominal wall nerve block they've delivered for the surgery itself.
The smaller incisions of minimally invasive hernia repair techniques reduce
the amount of trauma on tissue and result in less abdominal wall pain.
Without question, less tissue handling is better, surgeons say, but even with
experience and caution, there is still pulling, tugging and dissecting. That's
why they also advise delivering a local anesthetic injection into the area of
the incision shortly before it's made, to numb the pain of the work that's
about to be undertaken.
3. Place mesh carefully
Hernia repair is synonymous with surgical mesh usage. Almost all hernias are
best repaired with mesh, and surgeons say their choice of mesh depends as
much on the type of case they're doing as on the surgical facility's purchasing
patterns.
Synthetic, non-absorbable, permanent meshes made from polypropylene,
polyester and PTFE are commonly used. Some are coated with additives to pro-
vide a measure of protection against adhesion or infection. Alternatively, mesh-
es made from biological materials can be used when an infection is present in
H E R N I A R E P A I R
GRASP
AND GO
Laparoscopic
devices are
available
to assist in positioning mesh at the defect.
Pamela
Bevelhymer,
RN,
BSN
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