Bilateral lumbar hernia: challenges and anaesthetic considerations: A series of rare cases

Abstract

Lumbar hernia is the protrusion of extraperitoneal or intraperitoneal contents through a defect in the posterolateral abdominal wall. Reported cases of primary lumbar hernias are very few, making it the rarest form of abdominal hernias. Though the surgical management of primary bilateral lumbar hernias have been often reported, the anaesthetic considerations are seldom discussed. Three cases of bilateral lumbar hernia in men aged between 55-70 years are presented here. Case 1 was operated laparoscopically under general anaesthesia. Case 2 underwent an open bilateral lumbar hernia repair under spinal anaesthesia and Case 3 was again operated laparoscopically under combined epidural-general anaesthesia. We used three different anaesthesia techniques to anaesthetise these patients. It was found that patients under general anaesthesia were much more comfortable on waking up from anaesthesia. An epidural analgesia proved to be a very good adjuvant to general anaesthesia to reduce postoperative pain.