de Sá Ribeiro Flavio Antonio, Padron Fernanda, Castro Tiago Duarte Magalhães, Torres Filho Lucio Carlos de Azevedo, Fernandes Baltazar de Araujo
The First Surgical Clinic, Hospital Geral de Bonsucesso, Rio de Janeiro, RJ, Brazil.
Rev Col Bras Cir. 2010 Dec;37(6):397-402.
To demonstrate the feasibility of inguinal hernia repair with local anesthesia in an outpatient regime, with safety, efficacy and short learning curve.
We prospectively evaluated 454 patients undergoing inguinal hernia repair under local anesthesia on an outpatient basis between November 2004 and August 2008. Of the total number of hernias surgically treated in this period, 285 were operated on the right, 163 on the left and six bilateral. We used clinical, surgical and psychosocial criteria for inclusion in the procedure. The parameters for exclusion were complex, irreducible or recurrent hernia, obesity (BMI greater than 30 kg/m²), patient's refusal and psychiatric disorder. All patients underwent elective surgery and were analyzed regarding surgical outcome, complications and hospital stay.
All operations were completed successfully. In no case there was need to change the anesthetic method. Surgical time was similar to that conducted with other methods of anesthesia and there were no cases of adverse effects of local anesthetics. Intra-operative complications amounted to approximately 2.64% (12/454). There was no need for hospital admissions greater than 24 hours.
The procedure is feasible and causes no perioperative significant pain, is safe, can be performed by residents under supervision, has satisfactory patient acceptance and complications similar to those observed in a conventional herniorrhaphy, allowing lower time and cost of hospitalization and faster access to treatment.
证明在门诊采用局部麻醉进行腹股沟疝修补术的可行性，该方法具有安全性、有效性且学习曲线短。
我们前瞻性评估了2004年11月至2008年8月期间在门诊接受局部麻醉下腹股沟疝修补术的454例患者。在此期间接受手术治疗的疝总数中，右侧手术285例，左侧手术163例，双侧手术6例。我们采用临床、手术和社会心理标准来纳入该手术。排除标准为复杂疝、难复性疝或复发性疝、肥胖（体重指数大于30kg/m²）、患者拒绝及精神障碍。所有患者均接受择期手术，并对手术结果、并发症和住院时间进行分析。
所有手术均成功完成。无一例需要更改麻醉方法。手术时间与采用其他麻醉方法时相似，且无局部麻醉药不良反应病例。术中并发症发生率约为2.64%（12/454）。无需住院超过24小时。
该手术可行，围手术期无明显疼痛，安全，可在监督下由住院医师进行，患者接受度良好，并发症与传统疝修补术观察到的相似，可缩短住院时间和降低费用，并能更快获得治疗。
