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[Inguinal hernia repair in children: importance of combined local anesthesia]
José Guilherme Minossi1, Hemerson César Picanço, Paulo Roberto Vasconcelos Paulucci
1Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil. jminossi@fmb.unesp.br
Insights
Local anesthesia with sedation is a safe and effective technique for pediatric inguinal hernia repair. This method offers a simple approach with minimal complications for children undergoing surgery.
Area of Science:
- Pediatric Surgery
- Anesthesiology
Context:
- Inguinal hernias are common in children.
- General anesthesia poses risks for pediatric patients.
Purpose:
- To evaluate a local anesthesia technique for pediatric inguinal hernia repair.
- To assess the safety and efficacy of this anesthetic approach.
Summary:
- A study involving 48 children (3 months to 12 years) undergoing inguinal hernia repair used local anesthesia (lidocaine nerve blocks) with sedation (ketamine and diazepam).
- The procedure was successful in all but one patient, with minor complications (hematomas) in three cases.
- This technique proved simple, safe, and effective for pediatric inguinal hernia repair.
Impact:
- Provides a safe and effective alternative to general anesthesia for pediatric inguinal hernia repair.
- Highlights the benefits of local anesthesia with sedation in pediatric surgical settings.
- Offers a potential method to reduce risks associated with general anesthesia in children.
Aim:
To describe an anesthetic technique, as well as the results of surgical treatment of the inguinal hernia in children.
Patients/Methods:
Forty-eight patients were submitted to inguinal hernia repair under local anesthesia at "Santa Casa de Misericórdia de Cerqueira César", State of São Paulo, Brazil. There were 34 male and 14 female patients, range from 3 months to 12 years old. Local anesthesia was performed with a dose of 5 mg/kg body weight of 1% lidocaine through iliohypogastric and ilioinguinal nerve blocks, medially to the anterior superior iliac spine, and at level of the pubic tubercle. Sedation was done with an association of ketamine (1 to 2 mg/kg) and diazepam (0,2 to 0,4 mg/kg).
Results:
In all patients except one the procedure was done without complications. In that patient the local anesthesia was not effective and was followed by inhalatory anesthesia. Surgical complications (blood collections) were observed in three patients: two at the scrotum and one at subcutaneous, with good evolution.
Conclusions:
We conclude that the use of local anesthesia associated to sedative is a simple and safe procedure for the inguinal hernia repair in children.