ABSTRACT
Two adult anticoagulated patients after valve replacement were scheduled for inguinal herniorrhaphy. For inguinal herniorrhaphy in adults, spinal anesthesia is a common anesthetic method. In order to avoid spinal hematoma due to spinal anesthesia, however, we employed general anesthesia combined with ilioinguinal nerve block. Following induction of anesthesia, a laryngeal mask airway was inserted. Ilioinguinal nerve block was performed with 0.25% bupivacaine 20ml. Ilioinguinal nerve block was effective for maintaining hemodynamic stability throughout the operation, and decreased postoperative pain. This technique appears to be a simple and safe method for providing effective and long-lasting perioperative analgesia following inguinal herniorrhaphy in adult patients.
Subject(s)
Anesthesia, General , Hernia, Inguinal/surgery , Nerve Block/methods , Aged , Anesthesia, Spinal , Anticoagulants/adverse effects , Bupivacaine , Contraindications , Humans , Ilium/innervation , Inguinal Canal/innervation , Laryngeal Masks , Male , Middle Aged , Pain, Postoperative/prevention & controlABSTRACT
BACKGROUND: The aim of this study was to investigate the appropriate dose of ropivacaine in efficacy and safety when administered for ilioinguinal/iliohypogastric nerve block in children undergoing inguinal herniorrhaphy. METHODS: Forty six children (aged 1-8 yr, classified ASA I-II) undergoing ambulatory surgery for inguinal herniotomy were randomly assigned to one of the three groups, according to the dosage of ropivacaine: group I (n = 15), group II (n = 16) and III (n = 15) received 1.875, 0.9375 and 0.5625 mg x kg(-1) of ropivacaine, respectively. Intraoperative hemodynamics and modified CHEOPS score at 1, 3 and 5 hours after operation were recorded. RESULTS: There were no significant differences among the three groups in the intraoperative hemodynamics, whereas postoperative modified CHEOPS scores were significantly higher in group III than the other groups. Trivial femoral nerve palsy occurred in one patient of the group II, and no other adverse effects were seen in any groups. CONCLUSIONS: These results suggest that more than 0.9375 mg x kg(-1) of ropivacaine might be recommended to obtain sufficient postoperative analgesia for the ilioinguinal/iliohypogastric nerve block in children undergoing inguinal herniorrhaphy.
Subject(s)
Amides , Anesthetics, Local , Autonomic Nerve Block , Hernia, Inguinal/therapy , Amides/administration & dosage , Anesthetics, Local/administration & dosage , Child, Preschool , Dose-Response Relationship, Drug , Female , Humans , Hypogastric Plexus , Male , RopivacaineABSTRACT
BACKGROUND: The effects of clinical doses of propofol on left ventricular (LV) systolic function remain controversial and LV diastolic function has not been evaluated during induction of anesthesia with propofol. We assessed the effects of propofol on LV systolic and diastolic function during induction of anesthesia in adult patients with transthoracic echocardiography. METHODS: Twenty-three patients, ASA 1-2 and age < 70 y.o., received propofol 2 mg x kg(-1) for induction of anesthesia. LV systolic function was evaluated by fractional shortening (FS), ejection fraction (EF), rate-corrected mean velocity of circumferential fiber shortening (Vcfc) and a contractile index, LV end-systolic wall stress (ESWS) versus Vcfc relation (ESWS-Vcfc relation). LV diastolic functions were assessed by analysis of transmitral flow velocity, peak early diastolic and late diastolic filling velocities (E wave and A wave), E/A ratio and E wave deceleration time (DT). RESULTS: After induction, propofol preserved FS, EF, Vcfc and ESWS-Vcfc relation and caused a significant decrease in E wave and A wave, and a significant increase in E/A ratio and maintained DT. CONCLUSIONS: During induction of anesthesia in adult patients, propofol preserved LV systolic and diastolic functions.
Subject(s)
Anesthesia, General , Anesthetics, Intravenous/pharmacology , Diastole/drug effects , Propofol/pharmacology , Systole/drug effects , Ventricular Function, Left/drug effects , Adult , Echocardiography , Female , Humans , Male , Middle AgedABSTRACT
BACKGROUND: The effect of inhalation induction with sevoflurane on left ventricular(LV) function has not been evaluated in adults. We assessed the effect of inhalation induction with sevoflurane on left ventricular systolic and diastolic function in adult patients using transthoracic echocardiography. METHODS: Twenty-five patients (ASA 1-2 and age < 70 years) received inhalation induction with 5% of sevoflurane. LV systolic function was evaluated by fractional shortening (FS), ejection fraction (EF), rate-corrected mean velocity of circumferential fiber shortening (Vcfc) and a contractile index, LV end-systolic wall stress (ESWS) versus Vcfc relation (ESWS-Vcfc relation). LV diastolic function was assessed by analysis of transmitral flow velocity, peak early diastolic and late diastolic filling velocities (E wave and A wave), E/A ratio and E wave deceleration time (DT). RESULTS: After induction, sevoflurane caused significant decreases in FS, EF, Vcfc, ESWS-Vcfc relation, E wave, and A wave, and a significant increase in E/A and maintained DT. CONCLUSIONS: During inhalation induction with sevoflurane in adult patients, sevoflurane caused negative inotropic effects, but preserved LV diastolic function.
