Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
Umbilical and epigastric hernias are occasionally seen in patients with groin hernias, however, there is almost no published evidence about their simultaneous repair. In a 3-year period, 10 patients were subjected to simultaneous repair of groin hernias (7 unilateral, 2 bilateral inguinal and 1 femoral) and ventral hernias (7 primary, 2 recurrent umbilical and 1 epigastric) with local infiltration anesthesia and intravenous sedation. The mean total bupivacaine dose was 18 (10- 30) mL and mean total lidocaine dose 21 (14-30) mL. The mean time to resuming normal daily activity was 5.5 days, whereas the time to car driving was 3-7 days. The oral analgesic (naproxen sodium) requirement was 6-10 tablets for 3-5 days. Patient acceptance was excellent. Simultaneous repair of groin and ventral hernias with local anesthesia in outpatient setting is feasible and associated with a low complication rate and maximum patient comfort.Umbilikalne i epigastrične hernije ponekad se nalaze u bolesnika s preponskom hernijom, međutim, gotovo da nema objavljenih podataka o njihovom istodobnom operacijskom liječenju. Tijekom 3-godišnjeg razdoblja istodobna operacija preponskih hernija (7 jednostranih, 2 obostrane ingvinalne i 1 femoralna) i ventralnih hernija (7 primarnih i 2 opetovane umbilikalne i 1 epigastrična) u lokalnoj infiltracijskoj anesteziji i intravenskoj sedaciji izvedena je u 10 bolesnika. Srednja ukupna doza bupivakaina bila je 10 (10-30) mL, a srednja ukupna doza lidokaina 21 (14-30) mL. Srednje vrijeme do povratka normalnih svakodnevnih aktivnosti bilo je 5,5 dana, a za upravljanje motornih vozilima 3-7 dana. Potreba za oralnim analgeticima (naproksen natrij) bila je 6-10 tableta kroz 3-5 dana. Bolesnici su izvrsno prihvatili ove zahvate. Istodobno rješavanje preponske i ventralne hernije uz lokalnu anesteziju u izvanbolničkim uvjetima izvedivo je, ima nisku stopu komplikacija i najvišu razinu udobnosti za bolesnika
