ABSTRACT
Objetivo: recientemente se ha producido renovado interés sobre la técnica anestésica en la cirugía de la hernia inguinal y las ventajas y los inconvenientes derivados de las diferentes técnicas anestésicas. En nuestro país no hay información acerca de la la técnica anestésica en la hernioplastia. Nuestro objetivo es realizar un estudio epidemiológico sobre las técnicas anestésicas en la cirugía de la hernia inguinal. Pacientes y métodos: estudio epidemiológico transversal, descriptivo y multicéntrico en 20 hospitales de España. Cada centro incluyó a 12 pacientes sometidos a herniorrafia y registró datos sociodemográficos, antecedentes patológicos, técnica realizada, parámetros de recuperación y complicaciones. Resultados: se incluyó a 238 pacientes (el 91% ASA I-II), con una media de edad de 57 (25-84) años, 213 varones y 25 mujeres. El régimen de hospitalización fue: cirugía ambulatoria un 47%, corta estancia un 26% y el resto con ingreso. Se realizó anestesia subaracnoidea en un 60%, anestesia general en un 27% y anestesia local con sedación, habitualmente benzodiacepinas, en un 13% de los casos. El alta de los pacientes intervenidos en (..) (AU)
Objective: Despite renewed interest in the management of anaesthesia during inguinal hernia surgery, there is a lack of data on trends in anaesthesia in Spain. The purpose of this study was to analyse the different anaesthetic techniques used in inguinal hernia surgery and their association with recovery, hospital stay, complications, and satisfaction with the technique. Patients and methods: Ours was a multicentre, descriptive, crosssectional epidemiological study performed at 20 Spanish hospitals. Each centre included 12 patients who underwent elective inguinal hernia repair. Data were collected on patient characteristics, clinical history, anaesthetic technique, post-operative recovery, and complications. Results: Data were collected on 238 patients, most of whom (91%)were ASA I or II, with a mean age of 57 years (25-84). Day surgery was performed in 47% of cases; 26% as one-day surgery, and the rest as inpatient surgery. Spinal anaesthesia was the most widely used technique (60%),followed by general anaesthesia (27%), and local anaesthesia with sedation (..) (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Hernia, Inguinal/surgery , Ambulatory Surgical Procedures/methods , Anesthesia/methods , Anesthetics/administration & dosage , Delayed Emergence from Anesthesia/prevention & control , Postoperative Complications/prevention & controlABSTRACT
OBJECTIVE: Despite renewed interest in the management of anaesthesia during inguinal hernia surgery, there is a lack of data on trends in anaesthesia in Spain. The purpose of this study was to analyse the different anaesthetic techniques used in inguinal hernia surgery and their association with recovery, hospital stay, complications, and satisfaction with the technique. PATIENTS AND METHODS: Ours was a multicentre, descriptive, cross-sectional epidemiological study performed at 20 Spanish hospitals. Each centre included 12 patients who underwent elective inguinal hernia repair. Data were collected on patient characteristics, clinical history, anaesthetic technique, post-operative recovery, and complications. RESULTS: Data were collected on 238 patients, most of whom (91%) were ASA I or II, with a mean age of 57 years (25-84). Day surgery was performed in 47% of cases; 26% as one-day surgery, and the rest as inpatient surgery. Spinal anaesthesia was the most widely used technique (60%), followed by general anaesthesia (27%), and local anaesthesia with sedation (13%) (pP<.0001). Discharge was within 6 hours with general anaesthesia and local anaesthesia in 94% and 100% of cases, respectively, compared with 68% for spinal anaesthesia (001). No differences were observed between anaesthetic techniques in terms of adverse effects, except for urinary retention in 10 male patients (mean age 68 years) all of whom had received spinal anaesthesia. CONCLUSIONS: Spinal anaesthesia is the most commonly used technique in Spain for inguinal hernia repair, although it is associated with a longer hospital stay (greater than 6h in 32% of cases) and a high incidence of urinary retention than other anaesthetic methods, in particular those with local infiltration. These techniques should be more vigorously implemented in daily practice.
Subject(s)
Anesthesia , Hernia, Inguinal/surgery , Herniorrhaphy , Anesthesia/methods , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , SpainABSTRACT
Objetivo: Recientemente se ha producido renovado interés sobre la técnica anestésica en la cirugía de la hernia inguinal y las ventajas y los inconvenientes derivados de las diferentes técnicas anestésicas. En nuestro país no hay información acerca de la la técnica anestésica en la hernioplastia. Nuestro objetivo es realizar un estudio epidemiológico sobre las técnicas anestésicas en la cirugía de la hernia inguinal. Pacientes y métodos: Estudio epidemiológico transversal, descriptivo y multicéntrico en 20 hospitales de España. Cada centro incluyó a 12 pacientes sometidos a herniorrafia y registró datos sociodemográficos, antecedentes patológicos, técnica realizada, parámetros de recuperación y complicaciones. Resultados: Se incluyó a 238 pacientes (el 91% ASA I-II), con una media de edad de 57 (25-84) años, 213 varones y 25 mujeres. El régimen de hospitalización fue: cirugía ambulatoria un 47%, corta estancia un 26% y el resto con ingreso. Se realizó anestesia subaracnoidea en un 60%, anestesia general en un 27% y anestesia local con sedación, habitualmente benzodiacepinas, en un 13% de los casos. El alta de los pacientes intervenidos en régimen de cirugía ambulatoria fue entre 1 y 6 h en el 94 y el 100% de los casos de anestesia general y anestesia local respectivamente, frente a un 68% para la anestesia subaracnoidea. No hubo diferencias en las características del dolor, náuseas y vómitos entre las técnicas anestésicas; sin embargo, hubo 10 episodios de retención urinaria, todos ellos en el grupo de anestesia subaracnoidea, en pacientes varones y con una edad media de 68 años. Conclusiones: La anestesia subaracnoidea es la más utilizada en España para la herniorrafia, y se asocia con una elevada incidencia de retención urinaria y retraso en el alta hospitalaria (> 6 h en un 32% de los casos) en comparación con la anestesia local. Esta debería ser promovida activamente en nuestro país(AU)
No disponible
Subject(s)
Humans , Male , Female , Hernia, Inguinal/drug therapy , Hernia, Inguinal/surgery , Anesthesia/methods , Anesthesia , Preanesthetic Medication/trends , Preanesthetic Medication , Receptors, GABA-A/therapeutic use , Anesthesia, General/methods , Anesthesia, General , Anesthesia, Local , Epidemiologic Studies , Epidemiologic Factors , 28374Subject(s)
Buttocks , Foreign Bodies/diagnostic imaging , Foreign Bodies/surgery , Humans , Male , Ultrasonography , Young AdultABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Foreign Bodies/surgery , Foreign Bodies , Ultrasonography/trends , Ultrasonography , Anesthesia, Local/methods , Mepivacaine/therapeutic use , Radial Artery/surgery , Radial Artery , Anesthesia, Local/instrumentation , Anesthesia, Local/trendsSubject(s)
Ethmoid Sinusitis/complications , Headache/etiology , Maxillary Sinusitis/complications , Post-Dural Puncture Headache/diagnosis , Adult , Anesthesia, Spinal , Arthroscopy , Diagnosis, Differential , Ethmoid Sinusitis/diagnosis , Female , Headache/diagnosis , Humans , Magnetic Resonance Imaging , Maxillary Sinusitis/diagnosis , Polyps/complications , Polyps/diagnosis , RecurrenceABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Headache/etiology , Ethmoid Sinusitis/complications , Anesthesia, Spinal/adverse effects , Diagnosis, Differential , Ethmoid Sinusitis/diagnosisABSTRACT
OBJECTIVE: To study the efficacy and complications of a parascalene block over a period of 10 years of experience. MATERIAL AND METHODS: Since 1993 we have been performing parascalene blocks with 18G, 45 mm needles with 30 degrees bevels using the aponeurotic click method. We administer 30 mL of 1.5% mepivacaine and then insert a flexible catheter into the sheath surrounding the plexus to provide additional doses of 1% mepivacaine to ensure the surgical block of the inferior nerve trunk and/or postoperative analgesia. RESULTS: The parascalene block technique was used in 2810 patients for shoulder and arm surgery. The block succeeded in 2524 cases (89.82%) and failed in 286 (10.17%). Anesthetic efficacy was excellent in 1921 cases (76.10%), good in 289 cases (11.45%), and insufficient in 312 (12.36%). The most common complications were Bernard-Horner syndrome (71.31%), and ipsilateral hemidiaphragm paralysis (95.72%). Vasovagal events presented in 92 (4.65%) of the shoulder operations in semi-recumbent position. No cases of pneumothorax, respiratory insufficiency, arterial puncture, neuroaxial anesthesia, or medullary or radicular lesion occurred. CONCLUSION: The parascalene block is a simple, safe, and effective technique. The probability of serious complications is lower than with most known supraclavicular techniques, mainly because the puncture is perpendicular to the horizontal plane. A neurostimulator or aponeurotic click technique is used and the nerve trunks can be found between 1,5 and 2 cm deep when the plexus is located in reference to the transverse processes.
