scholarly journals PREVENTION OF POST SPINAL HYPOTENSION;

2012 ◽  
Vol 19 (03) ◽  
pp. 292-296
Author(s):  
MUHAMMAD BOOTA ◽  
BILAL Baig ◽  
SALEEM IQBAL ◽  
Sajid Munir ◽  
Syed Tariq Mohsin
Keyword(s):  
Heart Rate ◽  
Inguinal Hernia ◽  
Arterial Pressure ◽  
Elderly Patients ◽  
Systolic Arterial Pressure ◽  
Hernia Surgery ◽  
Inguinal Hernia Surgery ◽  
Number Of Patients ◽  
Paravertebral Muscles ◽  
Spinal Hypotension

Objective: Objective of the study is to evaluate the efficacy of intramuscular ephedrine along with preloading in prevention ofpost spinal hypotension in elderly patients undergoing inguinal hernia surgery. Study design: This is a quasi experimental study. Place andduration of study: The study was conducted at the department of Anaesthesia and Intensive Care Combined Military Hospital, Peshawar overa period of one year. Patients and Methods: In a double-blind, randomized study, 80 elderly patients undergoing inguinal hernia surgery underspinal anaesthesia divided into two equal groups of A and B. Forty patients received i/m inj of ephedrine 45mg deep in the paravertebralmuscles immediately after injection of bupivacaine, and 40 received an equal volume of saline. Patients in both groups were given the samevolumes of fluid before anaesthesia. The incidence of hypotension (Systolic arterial pressure <90mmHg or <80 % of baseline) were recorded.and incidence of fall in the heart rate was recorded. Results: Systolic arterial pressure during the first 60 min after anaesthesia remainedsignificantly more stable in the ephedrine-treated group, and there was also a significantly smaller number of patients in this group who haddecreases in pressure of more than 30% of pre-block levels and fewer required rescue i.v. Ephedrine. An increase in heart rate or systolicpressure of > 20% from baseline was found in two patients in the ephedrine group and in one patient in the placebo group. Conclusions: Weconclude that ephedrine 45mg administered in the paravertebral muscles immediately after plain bupivacaine spinal anaesthesia is a simpleand effective means of reducing the incidence of hypotensive episodes in the elderly patient.

scholarly journals Open Maloney Repair for Adult Inguinal Hernia, 5 Years Experience in A Remote District

2018 ◽  
Vol 10 (1) ◽  
pp. 6-10
Author(s):  
Sami Ahmad ◽  
Nadim Ahmed ◽  
Jawher Lal Singha ◽  
Ferdoush Rayhan ◽  
ASM Farhad Ul Hassan ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Average Duration ◽  
Study Group ◽  
Hernia Surgery ◽  
Inguinal Hernias ◽  
Inguinal Hernia Surgery ◽  
Number Of Patients ◽  
Duration Of Surgery ◽  
Secondary Closure ◽  
The Right

Background: In a remote district city of Bangladesh, inguinal hernias were repaired by Maloney (Darning) method.Efficacy of Darning repair was compared in this study.Aims and Objectives: The aim of this study was to determine the feasibility of doing Maloney ( Darn ) repair for adult inguinal hernias by specialist surgeons at remote districts . Age of the patients in ourstudy were above 20 years.Study Design: A descriptive retrospective study.Materials and Methods:In our study we included 2000 patient of inguinal hernia surgery repairs from May 2012 through June 2017. In the patients of the study group we repaired inguinal hernia by Maloney ( Darning) technique. Number of patients were 2000 ( male 1990 [99.5%] female 10 [.5%] with a mean age of 45.7 years. There were 1002(50.1%) hernias on the right side, 890(44.5%) were on the left side and 108(5.4%) were bilateral. Among the hernias 1419 ( 70.9%) were indirect, 575 (28.7%) were direct and 4 (0.2%) were of both direct and indirect (Pantoolon type), 2 (0.1%) were of femoral hernia. All were of primary hernias, recurrent hernias and hernias in patients with apparently weak musculature were repaired by Lychtenistein method with prolein mesh and were not included in this stpudy. 60 (3%) patients had feature of incarceration and 20 (1%) patients presented with obstruction. Among the obstructed hernias 8 (.4%) had strangulation and in 2 (.1%) resection and anastomosis were required for gangrenous ileum. In rest of the cases of strangulation circulation returned after incising the constricting ring and hot mob compression. We used IV antibiotic for 24 hours stated with induction of anaesthesia followed by oral for next 6 days. We used Injection Ceftrixone followed by Cefixime and in some patients Flucloxacillin.Statistics Analysis Used: Simple frequencies, proportion and cross tabulation.Results: Average duration of surgery was 70 minutes. There was no perioperative mortality. 90 (4.5%) patients developed mild subcutaneous wound infection, haematoma occurred in 160 ( 8% ) patients and seroma found in 300 ( 15% ) patients. All haematoma and seroma subsided gradually. Only 1 patient needed secondary closure for infected wound gap. The average duration of hospitalization was 3 days. All patients in study group are still in contact with me. Three patients (0.15%) had recurrences. All the recurrent cases reported within 6 months of their operations. Among the three age of 2 patients was above 60 and one patient of age above 70 had Maloney hernia repair for obstructed hernia.Conclusion:In remote places where prolene mesh is not available or is costly we can repair inguinal hernia by Maloney operation with very simple antibiotics with good results in comparison with other methods.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 6-10

scholarly journals A Comparison of Three Fluid-Vasopressor Regimens Used to Prevent Hypotension during Subarachnoid Anaesthesia in the Elderly

1998 ◽  
Vol 26 (5) ◽  
pp. 497-502 ◽  
Author(s):  
J. C. M. Yap ◽  
L. A. H. Critchley ◽  
S. C. Yu ◽  
R. M. Calcroft ◽  
J. L. Derrick
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Arterial Pressure ◽  
Elderly Patients ◽  
Hip Fractures ◽  
Normal Saline ◽  
Computer Software ◽  
Systolic Arterial Pressure ◽  
The Elderly ◽  
Group A

We aimed to compare the efficacy of fluid preloading with two recently recommended fluid-vasopressor regimens for maintaining blood pressure during subarachnoid anaesthesia in the elderly. Sixty elderly patients requiring surgery for traumatic hip fractures received subarachnoid anaesthesia using 0.05 ml/kg of 0.5% heavy bupivacaine. Hypotension, i.e. systolic arterial pressure <75% of baseline, was prevented or treated by: A—normal saline 16 ml/kg plus intravenous ephedrine boluses (0.1 mg/kg); B—normal saline 8 ml/kg plus intramuscular depot ephedrine (0.5 mg/kg); or C—Haemaccel 8 ml/kg plus metaraminol infusion. Systolic arterial pressure and heart rate were recorded using custom-written computer software (Monitor, version 1.0). Systolic arterial pressure decreased in all groups after five minutes (P<0.001). Decreases were greatest in group A (P<0.05). Heart rate increased by 7% group A and decreased by 9% in group C (P<0.05). During the first hour, hypotension was present for 47%, 25% and 20% of the time in groups A, B and C respectively and overcorrection of systolic arterial pressure occurred in 19% of the time in group C. We conclude that treatment A was inadequate in preventing hypotension. Treatments B and C were more effective but were associated with an increased heart rate and overcorrection of systolic arterial pressure respectively.

scholarly journals Comparison of the effect of ginger capsule and diclofenac tablet on the relief of pain following inguinal hernia surgery

2019 ◽  
Vol 21 (3) ◽  
pp. 114-117
Author(s):  
Gholamreza Shabanian ◽  
Ali Satari
Keyword(s):  
Inguinal Hernia ◽  
Negative Effects ◽  
Postoperative Pain Control ◽  
Hernia Surgery ◽  
Analgesic Effects ◽  
Inguinal Hernia Surgery ◽  
Number Of Patients ◽  
Significant Difference ◽  
Health Domains ◽  
Duration Of Hospitalization

Background and aims: Postoperative pain control decreases negative effects on the health domains of the patients and their relatives in addition to reducing the costs and the duration of hospitalization. The aim of the present study was to comparatively investigate the analgesic effects of ginger and diclofenac tablets. Materials and Methods: In this clinical trial, 80 patients undergoing inguinal hernia surgery were randomly divided into two groups of 40. One group received 250 mg ginger capsule while the other one received 100 mg diclofenac tablet. Then, the patients were examined within 6 hours (every two hours) and their pain was assessed using the standard 10-point visual analogue scale. Finally, the data were analyzed using the SPSS, version 22. Results: Based on the results, there was no significant difference in pain severity between the two groups at 0, 2, 4, and 6 hours after recovery (P>0.05). In addition, no significant difference was observed in the duration of pain since the time of patient recovery between the two groups (P>0.05). Further, as regards the number of patients receiving pethidine, no difference was found between the two groups (P>0.05). Conclusion: In general, both ginger capsule and diclofenac tablet were similarly effective in relieving the pain after inguinal hernia surgery

New Four-fold Technique to Spread the Self-Gripping Mesh in Open Inguinal Hernia Surgery

2021 ◽  
Author(s):  
Arun Kumar Gupta ◽  
Aman Raj ◽  
Devadatta Poddar ◽  
Lalit Kumar Bansal ◽  
Peeyush Kumar ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
The Self ◽  
Hernia Surgery ◽  
Inguinal Hernia Surgery

scholarly journals Postoperative condition of patients as a result of treatment of inguinal hernias by laparoscopic and open methods

2021 ◽  
pp. 30-35
Author(s):  
V.V. Skyba ◽  
◽  
A.V. Ivanko ◽  
N.V. Voytyuk ◽  
V.V. Lysytsia ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Surgical Treatment ◽  
Open Access ◽  
Hospital Stay ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Lower Percentage ◽  
Hernia Surgery ◽  
Inguinal Hernias ◽  
Inguinal Hernia Surgery

Purpose – to analyze condition of patients after surgical treatment of inguinal hernias by laparoscopic and open methods. Materials and methods. A retrospective review of medical histories and outpatient charts of all patients who underwent inguinal hernia surgery at the Kyiv City Clinical Hospital No. 1 from January 2018 to July 2020 was conducted. Results. During the above period of time in our hospital open hernioplasty was performed in 86 patients, laparoscopic hernioplasty – 138 patients. With open hernioplasty, the average duration of surgical treatment was 40±12 minutes. The laparoscopic technique was 35±12 minutes. The length of hospital stay was significantly longer in the group of patients with the open method (48±12 hours) than in the group of laparoscopic plastic surgery (12±3 hours). From the group of patients who underwent open hernioplasty, 62 patients complained of long-term pain syndrome, from the group of laparoscopy – 12 patients. The cosmetic appearance was dissatisfied with 34 patients in the open access group and only 2 patients in the laparoscopic plastic group. Postoperative complications were observed in 34 patients who underwent surgical treatment through open access, and in 15 patients – by laparoscopy. Conclusions. The laparoscopic approach of inguinal hernia surgery is superior to open access, as it reduces the length of hospital stay, postoperative recovery, improves the aesthetic effect of the operation, reduces the frequency of infection of incisions. According to the results of the study, this technique gives a better result in the early postoperative period, a lower percentage of chronic pain and a higher degree of patient satisfaction compared to open access with the same low recurrence rate. Therefore, in our opinion, laparoscopic access to hernioplasty is the optimal method of treatment and can be recommended as a method of choosing inguinal hernia surgery. Postoperative assessment of the quality of life of patients after treatment of inguinal hernia by laparoscopic and open methods. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: inguinal hernia, laparoscopy, open access surgery, analysis of methods, operation.

scholarly journals P144 SPERMATIC CORD LIPOSARCOMA - A VERY RARE FINDING DURING INGUINAL HERNIA SURGERY

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Christian Gröger ◽  
Lena Kundel ◽  
Hardwig Riediger
Keyword(s):  
Inguinal Hernia ◽  
Spermatic Cord ◽  
Rare Condition ◽  
Minimal Invasive ◽  
Tumor Board ◽  
Fatty Tissue ◽  
Industrialized Countries ◽  
Hernia Surgery ◽  
Rare Finding ◽  
Inguinal Hernia Surgery

Abstract Aim Repair of inguinal hernia is one of the most common operations in general surgery in industrialized countries. Isolated spermatic cord liposarcoma is a very rare soft tissue tumor. Despite standardized diagnostic algorithms for inguinal hernia, it could be difficult to predict such a rare finding. Material and Methods We report a case of inadvertent inguinal liposarcoma excision during hernia surgery in a 72-year-old male patient. Except for polyposis coli there were no further illnesses. Results After a minimal invasive transabdominal preperitoneal (TAPP) repair of a symptomatic inguinal hernia last year a persistent scrotal swelling developed. Computed tomography (CT) showed a protrusion of fatty tissue into the scrotal sac. Diagnosis of scrotal hernia was made. We performed an open Lichtenstein procedure. The final pathologic examination revealed a highly differentiated liposarcoma. Staging was completed and the case was presented to a multidisciplinary sarcoma tumor board at our institution. As recommended, a inguinal reoperation was performed with wide excision. Conclusions Although a very rare condition, spermatic cord liposarcoma should be considered as a possible differential diagnosis for inguinal hernia surgery.

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