scholarly journals Tension-Free Inguinal Hernia Repair in Local Anaesthesia versus Spinal Anaesthesia

2022 ◽  
Vol 9 (3) ◽  
pp. 39-42
Author(s):  
Rajesh Kale ◽  
D Anil
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Complications ◽  
Spinal Anesthesia ◽  
Local Anesthesia ◽  
Cross Sectional Study ◽  
Anatomical Location ◽  
Cross Sectional ◽  
Total N ◽  
Tension Free ◽  
Scrotal Edema

Abstract Background: Inguinal hernia is a common presentation in surgical clinics. In the past, the hernia surgeries were done under general and spinal anesthesia. Recently local anesthesia is being increasingly used due to the increased efficacy of local anesthetics and economic reasons. We in the current study tried to evaluate the effectiveness of Lichtenstein repair under local anesthesia and spinal anesthesia and the overall outcomes of both methods. Methods: This cross-sectional study was conducted in the Department of General Surgery, Prathima Institute of Medical Sciences, Naganoor, Karimnagar. Successive cases of uncomplicated inguinal hernia were selected for the study. A total of n=60 cases randomly allotted in two groups The LA group and SA group were taken and studied. Post-operatively VAS scale was used to evaluate pain, other postoperative complications such as testicular swelling and pain, urinary retention, nausea/vomiting, postural hypotension, and wound infections were recorded. Results : The age of the patient varied from 20 to 80 years with the highest prevalence noted in the age group of 41 to 60 years. The Mean age of presentation is 51.3 years. The anatomical location and type of hernia are given in table 1. 60.9% of inguinal hernia in this study was an indirect type, 30.4% was direct, 6.5% was pantaloons type and 2.2% was Ogilvie's hernia. Out of 74 patients, 62.1% had a right-sided inguinal hernia compared to the left side which accounted for 37.8%. Complication records showed N=9(23.7%) of the SA group and n=8(22.2%) LA group developed scrotal edema and in total n=17(23%) developed scrotal edema. N=7(18.4%) patients in the SA group and n=7(19.4%) in the LA group developed seroma and in total patients, n=14(18.9%) developed seroma. Conclusion: Lichtenstein tension-free hernioplasty done under local anesthesia is with less immediate postoperative complications, also the best suitable for patients with medical comorbidities and those who are on antiplatelet therapy where spinal anesthesia is contraindicated.

A Comparative Study of Lichtenstein Tension Free Hernioplasty under Local Anesthesia and Spinal Anesthesia for Inguinal Hernia

2017 ◽  
Vol 8 (2) ◽  
pp. 68-76
Author(s):  
Rajashekhara Babu G. ◽  
◽  
Nischal N. ◽  
Edison Vadakkenchery Varghese ◽  
◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Comparative Study ◽  
Spinal Anesthesia ◽  
Local Anesthesia ◽  
Tension Free

scholarly journals Comparative study of postoperative complications of Lichtenstein Tension Free Repair and Pure Tissue Repairs like Modified Bassini or Shouldice at Nishtar Hospital Multan

2016 ◽  
Vol 10 (1) ◽  
Author(s):  
Muzaffar Aziz ◽  
Naveed Ahmad ◽  
Fakhra Anwar ◽  
Faizullah .
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Complications ◽  
Wound Infection ◽  
Complication Rates ◽  
Tension Free ◽  
Group I ◽  
Separate File ◽  
Scrotal Edema ◽  
Quasi Experimental ◽  
Group Ii

The objective of this study is to compare the postoperative complications of Lichtenstein tension free repair and pure tissue repairs like modified Bassini or Shouldice. This was an interventional (quasi experimental) study. This study was carried out on 100 patients having primary inguinal hernia. After taking detail history, examination and necessary investigations, only tit patients were included in the study and rest were excluded. A separate file was maintained for each patient to note the complication rate of different hernia`s repairs. Patients in group I underwent modified Bassini (35%) and Shouldice repair (15%). Patients in group II underwent Lichtenstein repair (50%).30 (30%) complications were observed. Out of these 23(23%) were in group I and 7(7%) were in group II. All were managed conservatively. The main complications were wound hematoma (9%), Wound infection (3%), scrotal edema (1%), postoperative neuralgia (6%), retention of urine (8%) and recurrence (3%). Wound infection, wound hematoma and recurrence were seen more in group I. Post operative neuralgia was more common in group II. Although follow up was for a shorter period of time and complications like recurrence and post operative neuralgia could not be assessed accurately. It was concluded that Lichtenstein tension free repair is simple and effective method of repairing inguinal hernia, with low complication rates and low recurrence rate. The method is much easier and should be considered in majority of patients with inguinal hernia.

Clinical and Biochimical Comorbidities and Complications in Abdominal Surgery Using Synthetic Prosthetic Material

2018 ◽  
Vol 69 (6) ◽  
pp. 1519-1523
Author(s):  
Vlad Dumitru Baleanu ◽  
Danut Vasile ◽  
Alexandru Marian Goganau ◽  
Paul Ioan Tomescu ◽  
Dragos Davitoiu ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Abdominal Wall ◽  
Abdominal Wall Hernia ◽  
Prosthetic Material ◽  
Hernia Surgery ◽  
Tension Free ◽  
Elective Repair ◽  
Scrotal Edema ◽  
Remarkable Recovery ◽  
Risks Assessment

Hernia can be defined as an organ disorder which protrudes the wall that contains it. Synthetic material for the repair of the abdominal wall are used frequently with good results and less complications. Our research included a number of 135 patients diagnosed with inguinal hernia hospitalized and operated in Clinical County Hospital of Craiova, between 1st January 2017-31 October 2017. The purpose of our work was to identify and analyze comorbidities and complications for inguinal hernia repaired with synthetic prosthetic material. hernia repair was performed in 135 patients, 16 were women and 119 were men. Tension free meshplasty was accomplished in 131 patients with uncomplicated inguinal hernia and herniorrhaphy was successfully performed at 4 patients with complicated inguinal hernia. From our study 107 patients had a remarkable recovery without any complication. Patients who underwent tension-free hernia surgery using prosthetic mesh,short-term complications were represented by 19 patients with urinary retention, 6 surgical local infection (superficial infections) and 2 scrotal edema. Nowadays surgeons try to find the best elective repair of inguinal hernia,to be safety for the patients despite of their age and with few complications and low mortality rate. Risks assessment include general conditions and associated comorbidities of the patients. In our study we reveal the type of comorbidities which we meet. We considered that it is significant to optimize cardiopulmonary status and the other comorbidities of the patient before to repair abdominal wall hernia in order to avoid both short and long term complication.

Cognitive Performance and Neuro-Metabolites in HIV using 3T Magnetic Resonance Spectroscopy: A Cross-Sectional Study from India

2020 ◽  
Vol 18 ◽  
Author(s):  
Kartik Gupta ◽  
Shivabalan ◽  
Virendra Kumar ◽  
Surabhi Vyas ◽  
RM Pandey ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Motor Skills ◽  
Cross Sectional Study ◽  
Resonance Spectroscopy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Total N ◽  
Simple Motor

Background: Cognitive impairment in patients with human immunodeficiency virus (HIV) is associated with higher morbidity. The prevalence of and the metabolite changes in the brain associated with cognitive impairment in anti-retroviral therapy naïve patients with HIV is unknown. Objective: To estimate the prevalence of, and the neurometabolites associated with cognitive impairment in antiretroviral therapy (ART) naïve patients with HIV. Methods: We conducted a cross-sectional study among ART naïve patients with HIV aged 18-50 years in a tertiary care center in India. Cognition was tested using the Post Graduate Institute battery of brain dysfunction across five domains; memory, attentioninformation processing, abstraction executive, complex perceptual, and simple motor skills. We assessed the total N-acetyl aspartyl (tNAA), creatine (tCr) and glutamate + glutamine (Glx) using 3T magnetic resonance spectroscopy. Cognitive impairment was defined as an impairment in ≥2 domains. Results: Among 43 patients eligible for this study, the median age was 32 years (IQR 29, 40) and 30% were women. Median CD4 count and viral load were 317 cells/µL (IQR 157, 456) and 9.3 copies/ µL (IQR 1.4, 38), respectively. Impairment in at least one cognitive domain was present in 32 patients (74.4%). Impairment in simple motor skills and memory was present in 46.5% and 44% of patients, respectively. Cognitive impairment, defined by impairment in ≥2 domains, was found in 22 (51.2%) patients. There was a trend towards higher concentration of tNAA (7.3 vs. 7.0 mmol/kg), tGlx (9.1 vs. 8.2 mmol/kg), and tCr (5.5 vs. 5.2 mmol/kg) in the frontal lobe of patients with cognitive impairment vs. without cognitive impairment but it did not reach statistical significance (p>0.05 for all). There was no difference in the concentration of these metabolites in the two groups in the basal ganglia. Conclusions: There is a high prevalence of cognitive impairment in ART naïve patients with HIV. There is no difference in metabolites in patients with or without cognitive impairment. Further studies, with longitudinal follow-up, are required to understand the underlying pathophysiological mechanisms.

scholarly journals Perceived quality of surgical care in association with patient-related factors and correlation to reported postoperative complications in Finland: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037708
Author(s):  
Ira Helena Saarinen ◽  
Jaana-Maija Koivisto ◽  
Antti Kaipia ◽  
Elina Haavisto
Keyword(s):  
Quality Of Care ◽  
Postoperative Complications ◽  
Cross Sectional Study ◽  
Perceived Quality ◽  
Living Alone ◽  
Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Perceived Quality Of Care

ObjectiveTo study if patient-related factors are associated with patient-evaluated quality of care in surgery. To examine if there is an association with postoperative complications and patient-evaluated low quality of care.DesignA correlation cross-sectional study, in addition, a phone call interview at 30 days postoperatively to examine complications.SettingThe data on patients admitted for non-cardiac general and orthopaedic surgery at a central hospital in Southwestern Finland were collected in two phases during an 8-month period.Participants436 consecutive consenting and eligible in-ward non-cardiac general surgery and orthopaedic surgery adult patients. Ambulatory, paediatric and memory disorder patients were excluded. 378 patients completed the questionnaire (Good Nursing Care Scale for Patients (GNCS-P)).MethodsPerceived quality of care was examined by the GNCS-P questionnaire. Patient-related factors were obtained from electronic patient records and questionnaire. A telephone interview related to postdischarge complications was conducted 30 days after discharge.Main outcome measuresPatient evaluation of quality of care at discharge, its association with patient-related factors and patient-reported postdischarge complications.ResultsThe overall quality was evaluated high or very high by the patients. The lowest overall quality of care rate was assessed by surgical patients living alone (p=0.0088) and patients who evaluated their state of health moderate or poor (p=0.0047). Surgical patients reporting postoperative complications after discharge evaluated lower overall quality of care (p=0.0105) than patients with no complications.ConclusionPatient demographic factors do not seem to influence the perceptions of the quality of care. Instead, subjective state of health and living conditions (living alone) may have an influence on the patient experience of quality of care. The perceived quality of care in healthcare staff technical and communication skills may have an association with reported postoperative complications.

scholarly journals Practice of spinal anesthesia among anesthetists in the operation room of referral hospital: Cross-sectional study

2020 ◽  
Vol 27 ◽  
pp. 145-148
Author(s):  
Yonas Admasu Ferede ◽  
Yonas Addisu Nigatu ◽  
Abatneh Feleke Agegnehu ◽  
Salh Yalew Mustofa
Keyword(s):  
Spinal Anesthesia ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Operation Room

scholarly journals FAILED SPINAL ANESTHESIA

2016 ◽  
Vol 23 (12) ◽  
pp. 1527-1530
Author(s):  
Mobeen Ikram ◽  
Abdul Samee ◽  
Muhammad Amir ◽  
Muhammad Imdad
Keyword(s):  
Pain Management ◽  
Caesarean Section ◽  
Spinal Anesthesia ◽  
Teaching Hospital ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Emergency Caesarean ◽  
Indirect Supervision ◽  
Study Setting

Objectives: To determine the frequency of failed spinal anesthesia in patientsundergoing caesarean section in a teaching hospital in Pakistan. Study Design: It was a cross– sectional study. Setting: Department of Anesthesia and Pain Management PAF HospitalSargodha. Period: January 2015 to May 2015. Methodology: A total of 293 pregnant patientsundergoing caesarean section under spinal anesthesia were included. After prehydration andessential monitoring, all patients were given spinal anesthesia with 25 G spinal needle at L3-L4 or L4-L5 level by 2nd year resident anesthesiologist under indirect supervision using 1.5 mlof hyperbaric spinal injection. Failure to achieve adequate block was managed by differentmodalities like sedation, analgesia with ketamine, repeat spinal anesthesia or to proceed withgeneral anesthesia. Results: Out of total of 293 patients, failed spinal occurred in 9 patients(3.07%). Out of these 9 patients, 02 patients (22.22%) were elective caesarean sections while07 cases (77.77%) were emergency caesarean sections. Conclusion: The chances of failedspinal anesthesia are more in emergency caesarean sections as compared to elective casesand failure rate of spinal anesthesia in PAF teaching hospital Sargodha is 3.07% which is slightlyhigher than 3%

scholarly journals Comparison of the Outcomes of Manual Small Incision Cataract Surgery (MSICS) and Phacoemulsification (PHACO) in Ghana

2021 ◽  
Vol 18 (3) ◽  
pp. 143-149
Author(s):  
Samuel Kyei ◽  
Ebenezer Zaabaar ◽  
Frank Assiamah ◽  
Michael Agyemang Kwarteng ◽  
Kofi Asiedu
Keyword(s):  
Visual Acuity ◽  
Postoperative Complications ◽  
Cataract Surgery ◽  
Medical Records ◽  
Cross Sectional Study ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Small Incision ◽  
Uncorrected Visual Acuity

Background: The growing middle-class population of Ghana has seen more people being employed in visually demanding occupations  and hence there is an increased desire for quality post-cataract surgical visual outcomes. This study aimed at comparing the outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification (PHACO) among Ghanaians. Methods: This was a retrospective cross-sectional study in which records of patients who underwent MSCIS or phacoemulsification by the same surgeon were reviewed. Results: Medical records of 248 eyes were reviewed, out of which 132 underwent PHACO and 116 had MSICS. A significant number of the  PHACO group had good (6/6–6/18) uncorrected visual acuity (UCVA) compared to the MSICS group at 1–2 weeks follow-up (p = 0.003) and 4–6 weeks follow-up (p = 0.002). MSICS resulted in a higher total astigmatic change compared to PHACO (p < 0.001). The PHACO grouphad a higher number of postoperative complications compared with the MSICS group (p <0.001). Postoperative borderline and poor  uncorrected visual acuity were associated with age, total astigmatic change, and postoperative complications. Conclusion: The postoperative UCVA outcomes at 4–6 weeks’ follow-up indicates that PHACO resulted in noticeably less spectacle dependency when compared to MSICS.

scholarly journals Standardized Phase Angle as a Prognostic and Nutritional Status Tool for Pancreatic Cancer Patients Undergoing Pancreaticoduodenectomy: A Cross-sectional Study (P12-025-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Wei Chen ◽  
Shengnan Zhou
Keyword(s):  
Pancreatic Cancer ◽  
Postoperative Complications ◽  
Nutritional Status ◽  
Cancer Patients ◽  
Phase Angle ◽  
Cross Sectional Study ◽  
Nutritional Risk ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nrs 2002

Abstract Objectives This study investigated the use of standardized phase angle (SPA), determined by bioelectrical impedance analysis (BIA), as a nutrition status tool and prognostic factor for complications associated with pancreaticoduodenectomy (PD) in pancreatic cancer patients. Methods A cross-sectional study was conducted with 49 participants. All participants were assessed for nutritional risk and nutritional status using Nutritional Risk Screening 2002 (NRS-2002), Subjective Global Assessment (SGA) tools, Global Leadership Initiative on Malnutrition (GLIM) tool and BIA. The Clavien-Dindo classification method for surgical complications was used to identify and classify postoperative complications. Independent-samples T-tests, chi-square tests and Spearman correlation analyses were used to evaluate the association between SPA, nutrition and postoperative complications. Results A total of 49 patients were enrolled, and 20 patients (40%) had postoperative complications. The SPA value for the nourished group was significantly higher than the SPA value for the malnourished group (P = 0.021, 0.019, 0.023). Patients who were below the SPA cut-off values (−1.015, −1.065, and −0.69) were more likely to have postoperative complications (P = 0.009), whereas NRS-2002, SGA, and GLIM scores were not associated with postoperative complications. The SPA value of the group with complications was significantly lower than that of the group without complications (P = 0.004). The SPA threshold value for predicting postoperative complications in pancreatic cancer was −1.095 (AUC 0.737; 95% CI, 0.59, 0.88; P = 0.005). Conclusions The SPA is a prognostic indicator of postoperative complications in pancreatic cancer patients undergoing PD and is an effective tool for assessing nutritional status in pancreatic cancer patients. Funding Sources none. Supporting Tables, Images and/or Graphs

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