老而精:外科医生处理腹股沟疝的方法

IF 0.1 Q4 SURGERY
M. Giuffrida, G. Nita, F. Biolchini
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引用次数: 0

摘要

目的:腹股沟疝修补术是一种常见的外科手术。在新冠肺炎大流行期间,它在世界范围内被广泛报道。为了解决麻醉师短缺的问题,我们引入了一种新的腹股沟疝修补方案。方法:该方案是外科医生和麻醉师之间强有力合作的结果。它是基于EHS建议和描述良好的经皮髂腹股沟-髂下腹和生殖器股神经阻滞。结果:400多名患者在我们的机构接受了治疗。该方案的应用使最初计划的脊柱麻醉明显减少。传统上与脊髓麻醉相关的并发症在80%的患者中没有报道。只有三名患者需要输注阿托品或氟马西尼,而无需麻醉师介入。结论:本方案的应用前景广阔。初步结果显示经皮髂腹股沟-髂下腹和生殖器股神经阻滞的安全性和有效性。这种麻醉与伤口保护器和充分的术后疼痛控制相结合,可以产生一个可重复的系统,避免麻醉师的出现。近年来医疗系统发生的变化应该是改善资源和成果的新机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Old but Gold: The Surgeon’s Affair to Manage Inguinal Hernia
Purpose: Inguinal hernia repair is a common surgical procedure. It was widely reported worldwide during the COVID-19 pandemic. To manage the lack of anesthesiologists, we have introduced a new protocol to manage inguinal hernia repair. Methods: This protocol is the result of a strong collaboration between surgeons and anesthesiologists. It was based on EHS recommendations and the well-described percutaneous ilioinguinal–iliohypogastric and genitofemoral nerves block. Results: More than 400 patients have been treated at our institution. The application of the protocol has led to a sensible reduction in initially planned spinal anesthesia. The complications traditionally related to spinal anesthesia have not been reported in 80% of the patients. Only three patients required the infusion of atropine or flumazenil without the need to involve anesthesiologist. Conclusion: The application of our protocol seems promising. Preliminary results have shown the safety and efficacy of percutaneous ilioinguinal–iliohypogastric and genitofemoral nerves block. The combination of this kind of anesthesia with wound protector and adequate postoperative pain control can lead to a reproducible system avoiding the not strictly necessary presence of an anesthesiologist. The changes that have occurred in the healthcare system in recent years should be new opportunities for the improvement of resources and results.
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