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[腹股沟疝复发:局部麻醉下的门诊手术]

[Recurrence of inguinal hernia: ambulatory surgery under local anesthesia].

作者信息

Callesen T, Bech K, Hesselfeldt P, Andersen J, Nielsen R, Roikjaer O, Kehlet H

机构信息

Hvidovre Hospital, Kirurgisk gastroenterologisk afdeling.

出版信息

Ugeskr Laeger. 1996 Dec 2;158(49):7057-60.

PMID:8999611
Abstract

In order to assess the feasibility of repair of a recurrent inguinal hernia in unmonitored local anaesthesia in an ambulatory set-up pain scores and data on patient satisfaction were obtained from 76 unselected patients after 79 consecutive operations. Median age was 63 years, and 25%- and 75% quartiles were 49 and 72 years respectively. All operations were conducted in local anesthesia. Three patients stayed in hospital overnight after the operation. Pain: After one, six and 28 days 27, 14 og 7% respectively had severe pain during function (cough and/or rising). Satisfaction: 82% were satisfied with ambulatory surgery in local anaesthesia, 82% were satisfied with the analgesic therapy (tenoxicam and methadone), but one third needed supplementary analgesics during the first week (acetaminophen was recommended). It is concluded, that ambulatory repair of a recurrent inguinal hernia in unmonitored local anaesthesia is a safe and cost effective alternative to operation in general or spinal anaesthesia.

摘要

为评估在非住院环境下于未监测的局部麻醉中修补复发性腹股沟疝的可行性,我们在连续79例手术后,从76例未经挑选的患者处获取了疼痛评分及患者满意度数据。患者年龄中位数为63岁,25%分位数和75%分位数分别为49岁和72岁。所有手术均在局部麻醉下进行。3例患者术后留院过夜。疼痛情况:术后1天、6天和28天,分别有27%、14%和7%的患者在功能活动(咳嗽和/或起身)时出现剧痛。满意度:82%的患者对局部麻醉下的非住院手术感到满意,82%的患者对镇痛治疗(替诺昔康和美沙酮)感到满意,但三分之一的患者在第一周需要补充镇痛药(推荐使用对乙酰氨基酚)。结论是,在未监测的局部麻醉下对复发性腹股沟疝进行非住院修补是一种安全且具有成本效益的选择,可替代全身麻醉或脊髓麻醉下的手术。

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