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