Direct Comparison of PHS(R) and Perfix(R) Herniorrhaphy under Local Anesthesia

Purpose: The aims of this study were to evaluate the feasibility of local anesthesia in tension-free herniorrhaphy, using prosthetic mesh, and to directly compare PHSⓇ and PerfixⓇ herniorrhaphy under local anesthesia. Methods: Patients with a groin hernia, who underwent tension-free herniorrhaphy (n=107) under local anesthesia between March 2003 and February 2006, were included. PHSⓇ (n=63) and PerfixⓇ (n=44) meshes were randomly used, with no difference between the PHSⓇ and PerfixⓇ groups in relation to mean age, gender, number of combined diseases, body mass index (BMI), recurred hernia and types of hernia. Results: Intraoperative analgesics and/or sedatives were used in 55 patients (51.4%) where local anesthesia was insufficient. In a univariate analysis, the additional use of intraoperative analgesics and/or sedatives was related to the patient’s age and BMI. The patients at an older age and with a lower BMI were more tolerant to local anesthesia. However, only the BMI was found to be a statistically significant factor from the multivariate analysis. There was no significant difference between the PHSⓇ and PerfixⓇ groups on the additional use of intraoperative analgesics and/or sedatives, the use of postoperative analgesics, length of hospital stay, complication and recurrence (P＞0.05). Conclusion: With tension-free herniorrhaphy using the PHSⓇ or PerfixⓇ mesh, local anesthesia was acceptable and securable, regardless of the mesh type used. Among these patients, those at an older age and with a lower BMI were more tolerant to local anesthesia. (J Korean Surg Soc 2006;72:57-62)