From the Aarhus University Hospital, Skejby, Denmark.
Female Pelvic Med Reconstr Surg. 2020 Dec 1;26(12):758-762. doi: 10.1097/SPV.0000000000000708.
Simple prolapse operations can be performed using local anesthesia. However, this has not been the case for advanced pelvic organ prolapse operations. The aim of this study was to investigate the patient-reported feasibility and acceptability of local anesthesia and light sedation for sacrospinous fixation (SSF).
This is a prospective observational study on 105 women who underwent SSF in a public outpatient setting from April 2016 to October 2017. They received infiltration anesthesia with mepivacaine or lidocaine together with a pudendal nerve block with Marcaine. Local anesthesia was supplemented by intravenous light sedation and pain reliever. A Local Anesthetic Intraoperative Experience Questionnaire was used to evaluate patient experience.
One patient was converted to general anesthesia. Eighty-eight women answered the questionnaires. Ninety-nine percent defined themselves as satisfied or very satisfied with the anesthesia. Little or no pain during the operation was reported by 92% and 92% would choose the same type of anesthesia again. No adverse effect of the anesthetic procedure was observed. The median (range) admission time was 12 (4.5-48) hours, and 81% of the patients could be discharged on the day of surgery. At follow-up after 8 weeks and 6 months, no patients reported adverse events to the anesthesia.
The SSF can be performed using local anesthesia and light sedation with high degree of patient satisfaction. These preliminary data indicate that the concept of ambulatory surgery might be implemented more widely if the use of local anesthesia is also applied to more advanced surgical procedures.
简单的脱垂手术可以在局部麻醉下进行。然而，对于高级盆腔器官脱垂手术来说，情况并非如此。本研究旨在探讨局部麻醉和轻度镇静用于骶骨固定术（SSF）的患者可接受性和可行性。
这是一项前瞻性观察研究，共纳入 2016 年 4 月至 2017 年 10 月在公立门诊环境下接受 SSF 的 105 例女性患者。她们接受甲哌卡因或利多卡因浸润麻醉，同时行阴部神经阻滞加 Marcaine。局部麻醉辅以静脉轻度镇静和止痛药。采用局部麻醉术中体验问卷评估患者的体验。
1 例患者转为全身麻醉。88 例女性回答了问卷。99%的患者对麻醉效果表示满意或非常满意。92%和 92%的患者报告术中疼痛轻微或无疼痛，92%的患者会再次选择相同类型的麻醉。未观察到麻醉过程的不良反应。中位（范围）入院时间为 12（4.5-48）小时，81%的患者可在手术当天出院。在术后 8 周和 6 个月随访时，无患者报告麻醉不良事件。
SSF 可在局部麻醉和轻度镇静下进行，患者满意度高。这些初步数据表明，如果局部麻醉也应用于更先进的手术，那么日间手术的概念可能会得到更广泛的实施。
