Infiltration of bupivacaine into the preperitoneal space and trocar incisions of patients undergoing laparoscopic totally extraperitoneal repair of unilateral inguinal hernia: a prospective randomized controlled observational study.

INTRODUCTION: Although laparoscopic repair of inguinal hernia is associated with reduced postoperative pain, it is not entirely painless. In addition to reducing the need for analgesic medication, postoperative complications, and hospitalization, postoperative pain control enables early return to normal activity. AIM: To evaluate the efficacy of bupivacaine instilled into the pre-peritoneal space and trocar incisions of patients undergoing laparoscopic totally extraperitoneal (TEP) repair of inguinal hernia. MATERIAL AND METHODS: Bupivacaine was instilled into the pre-peritoneal space and trocar incisions of the patients in group I (n = 23), whereas it was infiltrated only into the trocar incisions of the patients in group II (n = 21). No local anesthetic was administered to the patients in group III (n = 21). Postoperative pain was assessed using the Visual Analog Scale (VAS) at 4 and 24 h, and the dosage of analgesic medication was noted. RESULTS: No significant difference regarding age, gender, body mass index, ASA class, history of abdominal surgery, or smoking was noted between the three groups (p > 0.05). VAS score at 4 h was significantly higher in group III than in groups I and II (p < 0.05). The dosage of analgesic medication was significantly higher in group III than in groups I and II (p < 0.05), with no significant difference between groups I and II (p > 0.05). CONCLUSIONS: Infiltration of long-acting local anesthetic into the pre-peritoneal space and trocar incisions of patients undergoing laparoscopic TEP repair of inguinal hernia reduces the need for analgesic medication by reducing early postoperative pain.

Intestinal perforation that developed after chemotherapy in a patient diagnosed with non-Hodgkin lymphoma: A case report and review of literature.

INTRODUCTION: Non-Hodgkin Lymphomas (NHL) appear with the malign transformation of mature lymphocytes. Intestinal perforations are one of the most well-known complications of NHLs. In this review, a 29-year-old male patient who was diagnosed with NHL with gastrointestinal involvement that developed intestinal perforation after chemotherapy is presented. PRESENTATION OF CASE: A 29-year-old male patient who received systemic chemotherapy in another healthcare center due to Major B-Cell Lymphoma was examined because he had stomachache after the treatment. The patient was urgently taken to operation. In the exploration, there were partly mass lesions in all small intestine segments. It was determined that one of the lesion was perforated. Small intestine resection was applied. The pathology report on resection material was reported as High Grade Major B-Cell Lymphoma. DISCUSSION: In the treatment of Lymphoma with intestinal B-Cells, there is no consensus because this disease is rarely observed. Perforation may appear as a complication of the chemotherapy. Depending on the steroids given to the patient, perforation may develop, and the clinical symptoms may be masked. CONCLUSION: It must be born in mind that there may be intestinal involvement in patients diagnosed with NHL, and intestinal perforation may develop due to chemotherapy.