Osifo Osarumwense, Amusan Taiwu I
Department of Surgery, University of Benin Teaching Hospital, PMB 1111, Benin City, Nigeria.
Saudi Med J. 2010 Jan;31(1):53-8.
To report outcomes of giant inguinoscrotal hernia repair using local lidocaine anesthesia in a resource-poor subregion.
Patients treated with giant inguinoscrotal hernia at 2 private healthcare facilities in Nigeria were studied between January 2004 and December 2008.
A total of 134 patients aged between 13 and 70 (mean 32 +/- 7.6) years, accounting for 51.3% adults treated for groin hernias, had open repair of 136 giant inguinoscrotal hernia using lidocaine. Average duration of symptoms (14.5 years) before presentation was influenced by lack of awareness in 82 (61.2%) and financial constraint in 34 (25.4%). The procedure was well tolerated as local lidocaine alone was used in 124 (92.5%), but 10 (7.5%) patients who had incarceration-required sedation using diazepam and/or ketamine with no conversion to spinal or general anesthesia. Postoperative courses were uneventful as prophylactic antibiotics and paracetamol gave good results, those without incarceration ambulated and commenced oral intake after 24 hours. All were admitted between 48-72 hours before discharge and returned to normal vocation after a month. Scrotal hematoma(13.5%) and wound infection (4.5%) resolved within a month with no recurrence so far on 1-5 years follow-up.
Giant inguinoscrotal hernia repair using local lidocaine was well tolerated and obtained comparable results to spinal or general anesthesia in resource-poor regions.
报告在资源匮乏地区使用局部利多卡因麻醉修复巨大腹股沟阴囊疝的结果。
对2004年1月至2008年12月期间在尼日利亚两家私立医疗机构接受巨大腹股沟阴囊疝治疗的患者进行研究。
共有134例年龄在13至70岁（平均32±7.6岁）之间的患者，占接受腹股沟疝治疗的成年人的51.3%，使用利多卡因对136例巨大腹股沟阴囊疝进行了开放修复。就诊前症状的平均持续时间（14.5年）受82例（61.2%）缺乏认识和34例（25.4%）经济限制的影响。该手术耐受性良好，124例（92.5%）仅使用局部利多卡因，10例（7.5%）发生嵌顿的患者需要使用地西泮和/或氯胺酮镇静，未转为脊髓麻醉或全身麻醉。术后过程平稳，预防性使用抗生素和对乙酰氨基酚效果良好，未发生嵌顿的患者术后24小时即可下床活动并开始经口进食。所有患者在出院前48 - 72小时入院，一个月后恢复正常工作。阴囊血肿（13.5%）和伤口感染（4.5%）在一个月内消退，在1 - 5年的随访中至今无复发。
在资源匮乏地区，使用局部利多卡因修复巨大腹股沟阴囊疝耐受性良好，与脊髓麻醉或全身麻醉效果相当。
