Hernia Reduction Periprocedural Care

Updated: Jul 11, 2022
  • Author: Ajita R Shah, MD; Chief Editor: Vikram Kate, MBBS, PhD, MS, FACS, FACG, FRCS, FRCS(Edin), FRCS(Glasg), FIMSA, FFST(Ed), MAMS, MASCRS  more...
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Periprocedural Care

Equipment

Equipment used in hernia reduction includes the following:

  • Means of anesthesia or sedation
  • Cold compress
  • Gurney capable of Trendelenburg positioning
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Patient Preparation

Anesthesia

Anesthesia is generally not required for most reductions. Procedural sedation is recommended if the patient is a young child. Procedural sedation can also be used in adults if a difficult reduction is expected or if initial attempts without sedation are unsuccessful. Epidural anesthesia has also been successfully used and might be an alternative for infants. [17] Ilioinguinal nerve blocks have been used as an adjunct for pain control for inguinal hernias. [18, 19]

Positioning

For reduction of an inguinal hernia, the patient should be placed in a 20° Trendelenburg position (see the image below). Gravity pulls the bowel contents inward from the site of herniation and facilitates reduction. A supine position is appropriate for a hernia of the upper abdomen.

40-year-old man presents with left inguinal pain, 40-year-old man presents with left inguinal pain, swelling, and erythema consistent with left inguinal hernia. He is placed in Trendelenburg position to aid in reduction.
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