Tailored Surgery in Inguinal Hernia Repair. The Role of Subarachnoid Anesthesia: A Retrospective Study.

Inguinal hernia repair Prilocaine Subarachnoid anesthesia

Journal

Open medicine (Warsaw, Poland)
ISSN: 2391-5463
Titre abrégé: Open Med (Wars)
Pays: Poland
ID NLM: 101672167

Informations de publication

Date de publication:
2019
Historique:
received: 11 03 2019
accepted: 16 07 2019
entrez: 1 11 2019
pubmed: 2 11 2019
medline: 2 11 2019
Statut: epublish

Résumé

Safety and effectiveness evaluation of subarachnoid anesthesia implemented with hyperbaric Prilocaine in reduced dose (30mg) in combination with Fentanyl (20mcg), for the purpose of ensuring an optimal analgesia in open inguinal hernia repair. Although the local anesthesia is the first line treatment for open inguinal hernia repair, a minority of patients is not eligible because of obesity or big groin hernia, requiring a high dose of local anesthetic. Subarachnoid anesthesia implemented with hyperbaric Prilocaine in reduced dose in combination with Fentanyl may be a good alternative. Thirty patients were treated with intrathecal association of Prilocaine 30 mg and Fentanyl 20 mcg (group PF); they were compared to a group of fifty three ones, previously treated with a classic procedure with intrathecal Prilocaine 60 mg (group P). The sensitive blockage remained within an higher limit at T12 level in the patients of PF group, and a lower limit at S1 level 50 minutes after the anesthesia, while in the P group the anesthetic tended to migrate (p<0.0001). In PF group 70 minutes after the anesthesia 21 patients had a Bromage score equal to 0 and 9 patients equal to 9 (in P group, 19 patients had a score equal to 3, 8 to 2 and 3 to 1, p<0.0001). Subarachnoid anesthesia using Prilocaine 30 mg + Fentanyl 20 mcg could be stated as a viable alternative to local anesthesia in selected patients.

Identifiants

pubmed: 31667353
doi: 10.1515/med-2019-0070
pii: med-2019-0070
pmc: PMC6818077
doi:

Types de publication

Journal Article

Langues

eng

Pagination

639-646

Informations de copyright

© 2019 Piergaspare Palumbo et al., published by De Gruyter.

Déclaration de conflit d'intérêts

Conflict of interest Conflict of interest statement: Authors state no conflict of interest

Références

Can J Anaesth. 2018 Jul;65(7):837-838
pubmed: 29508151
Ann Ital Chir. 2013 Nov-Dec;84(6):661-5
pubmed: 23165318
Medicine (Baltimore). 2018 May;97(19):e0693
pubmed: 29742719
Acta Anaesthesiol Scand. 2013 Feb;57(2):249-56
pubmed: 23199005
Pan Afr Med J. 2017 Nov 13;28:223
pubmed: 29629009
Med Sci Monit. 2017 Mar 12;23:1261-1267
pubmed: 28285318
Yonsei Med J. 2015 Mar;56(2):535-42
pubmed: 25684006
Anaesth Crit Care Pain Med. 2016 Dec;35(6):417-421
pubmed: 27352633
Ann Ital Chir. 2018;89:75-80
pubmed: 29629886
J Clin Diagn Res. 2017 Jul;11(7):UC17-UC20
pubmed: 28893015
Anesth Essays Res. 2016 Sep-Dec;10(3):526-531
pubmed: 27746546
Hernia. 2009 Aug;13(4):343-403
pubmed: 19636493
J Anaesthesiol Clin Pharmacol. 2016 Apr-Jun;32(2):229-33
pubmed: 27275055
Ann R Coll Surg Engl. 2007 Jul;89(5):497-503
pubmed: 17688723
Curr Opin Anaesthesiol. 2013 Oct;26(5):613-20
pubmed: 26057879
Hernia. 2011 Feb;15(1):7-14
pubmed: 20676711
Curr Opin Anaesthesiol. 2014 Dec;27(6):597-604
pubmed: 25211156
Br J Anaesth. 2009 Nov;103(5):750-4
pubmed: 19797249
Anesth Essays Res. 2017 Jul-Sep;11(3):554-557
pubmed: 28928546
Minerva Anestesiol. 2014 Jun;80(6):685-91
pubmed: 24226495
Anesth Analg. 2010 Aug;111(2):568-72
pubmed: 20529983
Isr Med Assoc J. 2014 Apr;16(4):250-4
pubmed: 24834764
Rev Bras Anestesiol. 2012 Nov-Dec;62(6):753-61
pubmed: 23176984
Clinics (Sao Paulo). 2010 Jun;65(8):763-7
pubmed: 20835552
Anesth Essays Res. 2016 May-Aug;10(2):164-72
pubmed: 27212741
Hernia. 2018 Feb;22(1):1-165
pubmed: 29330835
Int J Surg. 2014;12 Suppl 2:S4-S7
pubmed: 25159543
ScientificWorldJournal. 2014;2014:608372
pubmed: 25379541

Auteurs

Piergaspare Palumbo (P)

Department of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy.

Sofia Usai (S)

Department of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy.

Chiara Amatucci (C)

Department of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy.

Saverio Cerasari (S)

Department of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy.

Bruno Perotti (B)

Department of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy.

Luca Ruggeri (L)

Department of Emergency, Anesthesia and Critical Care, "Sapienza" University of Rome, Rome, Italy.

Roberto Cirocchi (R)

Department of Surgical Sciences, University of Perugia, Perugia, Italy.

Guglielmo Tellan (G)

Department of Emergency, Anesthesia and Critical Care, "Sapienza" University of Rome, Rome, Italy.

Classifications MeSH