>Year 2005, Issue 4
Ambulatory hernioplasty of the abdominal wall under local and locoregional anesthesia by peripheral nerves blockade
Cir Gen 2005; 27 (4)
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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.
||Hernioplasty, mesh, local anesthesia, complications.
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>Year 2005, Issue 4