Acta Medica Medianae
Vol. 46, No 4, December, 2005 UDK 61 YU ISSN 0365-4478
Contakt:
Dragana Todorović
Medicinski fakultet
Bulevar Dr Zorana Đinđića 81
18000 Niš
Srbija i Crna Gora
Tel.: 063/87-80-847
|
ADMINISTRATION OF
EPIDURAL ANESTHESIA
IN OPERATIONS OF INGUINAL HERNIAS
– COMPARISON OF DIFFERENT ANESTHETICS’ CONCENTRATIONS
Dragana Todorović1, Slavko Konstatinović2 i
Radmilo Janković2
Medicinski fakultet u Nišu1
Hirurška klinika Kliničkog centra u Nišu2
In
operations of inguinal hernias, different techniques of anesthesia
administration are used, but in the last years, there has been a
great interest in the local-regional anesthesia, primarily in
epidural. The aim of the study was to ascertain the efficiency and
safety of administration of minor anesthetics’ concentrations in
epidural anesthesia in operations of inguinal hernias. The
assessment of patient’s stability by monitoring of vital functions
included: noninvasive measuring of blood pressure, pulse, ECG,
respiratory frequency and diuresis. Also, in order to assess the
effect of anesthetic action of lidocaine, we followed up the onset
and ending of sensory blockade, motor blockade, pain intensity
during surgical intervention with the use of VAS.
There was no statistically significant difference regarding the
onset and ending of sensory blockade between greater (20 ml 2%
lidocaine) and minor concentrations (20 ml 1,5% lidocaine)
administered epidurally. However, all the examinees to whom 2%
lidocaine was administered, had the motor blockade which occurred
after 14,37 ±1,04 min, and was in duration of 110,45±13,20 min. Only
20% of patients to whom 1,5% lidocaine was administered had the
motor blockade, in whom it occurred after 11,16± 2,02 min, and was
in duration of 100,30 ±8,40 min.
Systolic pressure significantly decreased between the fifth and
tenth minute after 20 ml of 2% lidocaine administration compared to
the group to whom 20 ml of 1,5% lidocaine was administered, with
statistical significance (p<0,01). Also, we registered decrease in
pulse frequency in both groups, as well as the fact that the
patients to whom 20 ml of 2% lidocaine was administered, had to stay
in bed longer in the postoperative period. Comparing other
hemodynamic parameters, there was no statistically significant
difference. We can conclude that minor concentrations of anesthetics
can be efficient and safe to administer in epidural anesthesia,
because they achieve adequate analgesia for a surgical intervention.
The possibility of toxic symptoms’ occurrence is smaller, when
compared to greater doses and concentrations of anesthetics. Acta
Medica Medianae 2005;44(4): 25 – 29.
Key words:
inguinal hernia, epidural anesthesia, comparison of different
anesthetics’ concentrations |