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2005, Number 4

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Cir Gen 2005; 27 (4)

Ambulatory hernioplasty of the abdominal wall under local and locoregional anesthesia by peripheral nerves blockade

Ramírez MLR
Full text How to cite this article

Language: Spanish
References: 17
Page: 286-290
PDF size: 61.80 Kb.


Key words:

Hernioplasty, mesh, local anesthesia, complications.

ABSTRACT

Objective:To describe and assess an anesthetic technique for ambulatory surgery of abdominal wall hernias by means of peripheral nerves blockade, which allows to discharge the patient immediately after surgery.
Setting:Second level social security hospital and private ambulatory surgery center.
Design:Prospective, observational, descriptive study, without control group.
Patients and methods:Data from all patients subjected to hernia repair between January 2003 and December 2004 were collected. Analyzed variables were: characteristics of the hernia, anesthetic and surgical techniques, sedation, postoperative stay, complications, and aggregated diseases.
Results:In a 2-years period, 134 patients were operated on 139 hernias. Twelve (9%) patients were operated under non-local anesthesia. The described technique was used in 122 (91%) patients for 125 hernias: 78 umbilical, 35 postincisional, 8 epigastric, and 4 Spiegel. Surgical techniques with and without mesh were used. All patients were anesthetized and operated by one surgeon assisted by an anesthesiologist. No conversion to another type of anesthesia occurred. Postoperative stay was of less than 30 min to a maximum of 2 hours. Complications consisted of two hematomas, three seromas, and one surgical wound infection. Acceptance was from good to excellent in 115 patients (94.2%). To this date, there are two recurrences.
Conclusion:The described technique allows for ambulatory surgery with an immediate discharge of patients subjected to abdominal wall hernia repair. It is the choice technique for the author and it is proposed as an alternative for patients at high risk for regional or general anesthesia.


REFERENCES

  1. Kingsnorth AN, Leblanc KA. Choice of anesthesia: general, regional or local anesthetic. In: Kingsnorth AN, Leblanc KA. Management of abdominal hernias. 3rd ed. London, New York: Edward Arnold publishers; 2003: 105-14.

  2. Vázquez-Mellado DA, García AJ. Anestesia local en las hernias abdominales e inguinales. En: Mayagoitia GJC. Hernias de la pared abdominal. Tratamiento actual. México: McGraw-Hill; 2004: 43-9.

  3. Maraboto AC. Manejo anestésico del paciente que será sometido a una hernioplastía. En: Roesch Dietlen F, Abascal Zamora R. Hernias de la pared abdominal. México: El Manual Moderno, 2001: 93-101.

  4. Davis JE. Cirugía general mayor en el paciente ambulatorio. Tratamiento de enfermedades mamarias y hernias de la pared abdominal. Clin Quir Norteam 1987; 67: 749-77.

  5. Amado WJ. Anestesia para las hernioplastías. Clin Quir Norteam 1993; 73: 459-72.

  6. Gianetta E, Civalleri D, Serventi A, Floris F, Mariani F, Aloisi F, et al. Anterior tension-free repair under local anesthesia of abdominal wall hernias in continuous ambulatory peritoneal dialysis patients. Hernia 2004; 8: 354-7.

  7. Deysine M, Grimson R, Soroff HS. Herniorrhaphy in the elderly. Benefits of a clinic for the treatment of external abdominal wall hernias. Am J Surg 1987; 153: 387-91.

  8. Menon VS, Brown TH. Umbilical hernia in adults: day case local anaesthetic repair. J Postgrad Med 2003; 49: 132-3.

  9. Malazgirt Z, Dervisoglu A, Polat C, Guneren E, Guven H, Akpolat T. Preperitoneal mesh repair of spigelian hernias under local anesthesia: description and clinical evaluation of a new technique. Hernia 2003; 7: 202-5.

  10. Kurzer M, Belsham PA, Kark AE. Tension-free mesh repair of umbilical hernia as a day case using local anaesthesia. Hernia 2004; 2: 104-7.

  11. Muschaweck U. Umbilical and epigastric hernia repair. Surg Clin North Am 2003; 83: 1207-21.

  12. Herszage L. Hernia surgery in the South American woodlands: a surgical adventure in Argentina. Hernia 2004; 8: 306-10.

  13. Cowdin HP Jr, Tiebwasser AS. Anesthetic considerations in the management of abdominal wall hernia. In: Fitzgibbons RJ Jr, Greenburg AG, ed. Nyhus and Condon’s Hernia. 5th ed. Philadelphia: Lippincott, Williams and Wilkins; 2001: 515-29.

  14. Löfström B. Bloqueo de los nervios intercostales. En: Manual ilustrado de anestesia local. Suecia: Astra Zeneca, 1969: 89-91.

  15. Tverskoy M, Cozacov C, Ayache M, Bradley EL Jr, Kissin I. Postoperative pain after inguinal herniorrhaphy with different types of anesthesia. Anesth Analg 1990; 70: 310-1.

  16. Shackelford RT, Grose WE. Anesthesia. Adult umbilical hernia. In: Shackelford and Zuidema’s Surgery of the alimentary tract. 2nd ed. Philadelphia: WB Saunders; 1986; 5: 165.

  17. Rutkow IM, Robbins AW. Aspectos demográficos, de clasificación y socioeconómicos en la reparación de hernia en Estados Unidos. Clin Quir Norteam 1993; 73: 443-58.




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Cir Gen. 2005;27