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.