Callesen T, Bech K, Kehlet H
Department of Surgical Gastroenterology, Hvidovre University Hospital, Denmark.
Anaesthesia. 1998 Jan;53(1):31-5. doi: 10.1111/j.1365-2044.1998.00244.x.
Data from 400 consecutive elective ambulatory operations for inguinal hernia under unmonitored local anaesthesia with limited pre-operative testing were prospectively obtained by the use of standardised files and questionnaires to assess the feasibility, patient satisfaction and potential cost reductions for such a technique. The median age of the patients was 59 years, and 29 operations were performed in ASA group III patients. The median postoperative hospital stay was 85 min. Conversion to general anaesthesia was necessary only in two cases, and nine patients needed overnight admission. One week postoperative morbidity was low with one case of transient cerebral ischaemia and one case of pneumonia, but no case of urinary retention. On follow-up, 88% were satisfied with the procedure, including unmonitored local anaesthesia. The cost reduction was at least 160 Pounds per patient compared with general/regional anaesthesia. We conclude that elective inguinal herniorrhaphy may be performed routinely under unmonitored local anaesthesia with a low postoperative morbidity, a high satisfaction rate and significant cost reductions.
通过使用标准化文件和问卷，前瞻性地收集了400例连续进行的腹股沟疝择期门诊手术的数据，这些手术在未监测的局部麻醉下进行，术前检查有限，目的是评估这种技术的可行性、患者满意度以及潜在的成本降低情况。患者的中位年龄为59岁，ASA III级患者进行了29例手术。术后中位住院时间为85分钟。仅2例需要转为全身麻醉，9例患者需要过夜住院。术后一周发病率较低，有1例短暂性脑缺血和1例肺炎，但无尿潴留病例。随访时，88%的患者对手术满意，包括未监测的局部麻醉。与全身/区域麻醉相比，每位患者至少节省160英镑。我们得出结论，择期腹股沟疝修补术可以在未监测的局部麻醉下常规进行，术后发病率低，满意度高，且成本显著降低。
