Inguinal hernia medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
*Pharmacologic medical therapies for patients with post-operative repair of inguinal hernia include:<ref name="pmid24920934">{{cite journal |vauthors=Bjurstrom MF, Nicol AL, Amid PK, Chen DC |title=Pain control following inguinal herniorrhaphy: current perspectives |journal=J Pain Res |volume=7 |issue= |pages=277–90 |year=2014 |pmid=24920934 |pmc=4045265 |doi=10.2147/JPR.S47005 |url=}}</ref><ref name="pmid23302973">{{cite journal |vauthors=Cohen SP, Galvagno SM, Plunkett A, Harris D, Kurihara C, Turabi A, Rehrig S, Buckenmaier CC, Chelly JE |title=A multicenter, randomized, controlled study evaluating preventive etanercept on postoperative pain after inguinal hernia repair |journal=Anesth. Analg. |volume=116 |issue=2 |pages=455–62 |year=2013 |pmid=23302973 |doi=10.1213/ANE.0b013e318273f71c |url=}}</ref><ref name="pmid23450576">{{cite journal |vauthors=Derry S, Sven-Rice A, Cole P, Tan T, Moore RA |title=Topical capsaicin (high concentration) for chronic neuropathic pain in adults |journal=Cochrane Database Syst Rev |volume= |issue=2 |pages=CD007393 |year=2013 |pmid=23450576 |doi=10.1002/14651858.CD007393.pub3 |url=}}</ref><ref name="pmid19801049">{{cite journal |vauthors=O'Connor AB, Dworkin RH |title=Treatment of neuropathic pain: an overview of recent guidelines |journal=Am. J. Med. |volume=122 |issue=10 Suppl |pages=S22–32 |year=2009 |pmid=19801049 |doi=10.1016/j.amjmed.2009.04.007 |url=}}</ref> | *Pharmacologic medical therapies for patients with post-operative repair of inguinal hernia include:<ref name="pmid24920934">{{cite journal |vauthors=Bjurstrom MF, Nicol AL, Amid PK, Chen DC |title=Pain control following inguinal herniorrhaphy: current perspectives |journal=J Pain Res |volume=7 |issue= |pages=277–90 |year=2014 |pmid=24920934 |pmc=4045265 |doi=10.2147/JPR.S47005 |url=}}</ref><ref name="pmid23302973">{{cite journal |vauthors=Cohen SP, Galvagno SM, Plunkett A, Harris D, Kurihara C, Turabi A, Rehrig S, Buckenmaier CC, Chelly JE |title=A multicenter, randomized, controlled study evaluating preventive etanercept on postoperative pain after inguinal hernia repair |journal=Anesth. Analg. |volume=116 |issue=2 |pages=455–62 |year=2013 |pmid=23302973 |doi=10.1213/ANE.0b013e318273f71c |url=}}</ref><ref name="pmid23450576">{{cite journal |vauthors=Derry S, Sven-Rice A, Cole P, Tan T, Moore RA |title=Topical capsaicin (high concentration) for chronic neuropathic pain in adults |journal=Cochrane Database Syst Rev |volume= |issue=2 |pages=CD007393 |year=2013 |pmid=23450576 |doi=10.1002/14651858.CD007393.pub3 |url=}}</ref><ref name="pmid19801049">{{cite journal |vauthors=O'Connor AB, Dworkin RH |title=Treatment of neuropathic pain: an overview of recent guidelines |journal=Am. J. Med. |volume=122 |issue=10 Suppl |pages=S22–32 |year=2009 |pmid=19801049 |doi=10.1016/j.amjmed.2009.04.007 |url=}}</ref> | ||
**Pain reliever | ** '''1. Pain reliever''' | ||
***Preferred regimen: Non-steroidal anti-inflammatory drugs(NSAIDs) 400mg PO q12h PRN | ***Preferred regimen: Non-steroidal anti-inflammatory drugs(NSAIDs) 400mg PO q12h PRN | ||
***Alternative regimen (1): Gabapentin 300 mg PO q8h PRN | ***Alternative regimen (1): Gabapentin 300 mg PO q8h PRN | ||
| Line 17: | Line 17: | ||
***Alternative regimen (3): Duloxetine 30 mg PO q24h for 1 week | ***Alternative regimen (3): Duloxetine 30 mg PO q24h for 1 week | ||
***Alternative regimen (4): Venlafaxine 75-225 mg PO q24h for 1 week | ***Alternative regimen (4): Venlafaxine 75-225 mg PO q24h for 1 week | ||
**Antibiotics | ** '''2. Antibiotics''' | ||
***Preferred regimen: Cefazolin 2 g IV for 7days | ***Preferred regimen: Cefazolin 2 g IV for 7days | ||
***Alternative regimen (1): Clindamycin 900 mg q8h for 7days | ***Alternative regimen (1): Clindamycin 900 mg q8h for 7days | ||
| Line 23: | Line 23: | ||
***Alternative regimen (3): Ciprofloxacin 400 mg IV for 10 days | ***Alternative regimen (3): Ciprofloxacin 400 mg IV for 10 days | ||
***Alternative regimen (4): levofloxacin 500 mg IV for 5 days | ***Alternative regimen (4): levofloxacin 500 mg IV for 5 days | ||
**Alternative regimen (5): Aztreonam 2 g IV q6-8h (not to exceed 8g/day) | |||
**Topical medications | **'''3. Topical medications''' | ||
***Lidocaine | ***Lidocaine | ||
***Capsaicin’s analgesic | ***Capsaicin’s analgesic | ||
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Overview
Medical Therapy
- Pharmacologic medical therapies for patients with post-operative repair of inguinal hernia include:[1][2][3][4]
- 1. Pain reliever
- Preferred regimen: Non-steroidal anti-inflammatory drugs(NSAIDs) 400mg PO q12h PRN
- Alternative regimen (1): Gabapentin 300 mg PO q8h PRN
- Alternative regimen (2): Pregabalin 300 mg PO q8h PRN
- Alternative regimen (5): Opioids 2-10 mg IV q2-4h PRN
- Alternative regimen (6): Tramadol 50-100mg PO q4-6h PRN
- Alternative regimen (3): Duloxetine 30 mg PO q24h for 1 week
- Alternative regimen (4): Venlafaxine 75-225 mg PO q24h for 1 week
- 2. Antibiotics
- Preferred regimen: Cefazolin 2 g IV for 7days
- Alternative regimen (1): Clindamycin 900 mg q8h for 7days
- Alternative regimen (2): Vancomycin 15 mg/kg IV for 7-10days
- Alternative regimen (3): Ciprofloxacin 400 mg IV for 10 days
- Alternative regimen (4): levofloxacin 500 mg IV for 5 days
- Alternative regimen (5): Aztreonam 2 g IV q6-8h (not to exceed 8g/day)
- 3. Topical medications
- Lidocaine
- Capsaicin’s analgesic
- 1. Pain reliever
References
- ↑ Bjurstrom MF, Nicol AL, Amid PK, Chen DC (2014). "Pain control following inguinal herniorrhaphy: current perspectives". J Pain Res. 7: 277–90. doi:10.2147/JPR.S47005. PMC 4045265. PMID 24920934.
- ↑ Cohen SP, Galvagno SM, Plunkett A, Harris D, Kurihara C, Turabi A, Rehrig S, Buckenmaier CC, Chelly JE (2013). "A multicenter, randomized, controlled study evaluating preventive etanercept on postoperative pain after inguinal hernia repair". Anesth. Analg. 116 (2): 455–62. doi:10.1213/ANE.0b013e318273f71c. PMID 23302973.
- ↑ Derry S, Sven-Rice A, Cole P, Tan T, Moore RA (2013). "Topical capsaicin (high concentration) for chronic neuropathic pain in adults". Cochrane Database Syst Rev (2): CD007393. doi:10.1002/14651858.CD007393.pub3. PMID 23450576.
- ↑ O'Connor AB, Dworkin RH (2009). "Treatment of neuropathic pain: an overview of recent guidelines". Am. J. Med. 122 (10 Suppl): S22–32. doi:10.1016/j.amjmed.2009.04.007. PMID 19801049.