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用于腹股沟、阴囊及睾丸手术的局部浸润和精索阻滞

Local infiltration and spermatic cord block for inguinal, scrotal and testicular surgery.

作者信息

Magoha G A

机构信息

Department of Surgery, College of Health Sciences, University of Nairobi, Kenya.

出版信息

East Afr Med J. 1998 Oct;75(10):579-81.

Abstract

This was a prospective study involving 372 male patients. Surgical procedures including simple inguinal hernia repair, inguinal lymph node biopsy, hydrocelectomy, testicular biopsy, testicular fixation, orchidectomy and scrotal exploration were performed under local anaesthesia using various quantities of 0.5% xylocaine with adrenaline depending on the procedure, in the form of spermatic cord block and local infiltration nerve blocks. No premedication was given to any patient and only five patients (1.34%) were given intraoperative sedation due to anxiety. No complication directly attributed to the anaesthetic agent used or the technique of spermatic cord and nerve blocks were reported during the study. Three hundred and sixty patients (96.77%) were operated on as outpatients and were happy and satisfied to return home on the same day. This experience confirms that spermatic cord block accompanied by local infiltration with 0.5% xylocaine with adrenaline is simple, safe and effective technique that should be used more widely in outpatient urological and general surgical settings in this locality. It provides excellent intra-scrotal and inguinal anaesthesia. Furthermore, the technique is cost effective, and personnel effective since no anaesthetist is required for the procedure which is usually carried out by the surgeon. This would enable many more people to afford the surgical procedures.

摘要

这是一项涉及372名男性患者的前瞻性研究。手术操作包括单纯腹股沟疝修补术、腹股沟淋巴结活检术、鞘膜积液切除术、睾丸活检术、睾丸固定术、睾丸切除术和阴囊探查术,根据手术情况,在局部麻醉下使用不同剂量的含肾上腺素的0.5%利多卡因,采用精索阻滞和局部浸润神经阻滞的方式。未对任何患者进行术前用药,仅有5名患者(1.34%)因焦虑在术中接受了镇静。研究期间未报告任何直接归因于所用麻醉剂或精索及神经阻滞技术的并发症。360名患者(96.77%)作为门诊患者接受手术,并且很高兴和满意在同一天回家。这一经验证实,0.5%利多卡因加肾上腺素局部浸润联合精索阻滞是一种简单、安全且有效的技术,应在该地区的门诊泌尿外科和普通外科环境中更广泛地应用。它能提供出色的阴囊内和腹股沟麻醉。此外,该技术具有成本效益且人员效率高,因为该手术通常由外科医生进行,无需麻醉师。这将使更多人能够负担得起手术治疗。

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