1/3. Repair of concomitant inguinal and femoral hernias under local anaesthesia.We describe the case of a 91-year-old patient with small bowel obstruction due to an obstructed groin hernia. It was decided to repair the hernia under local anaesthesia and sedation because of the patient's age and medical condition. At surgery, concomitant inguinal and femoral hernias were found and repaired. We discuss the technique of repairing groin hernias under local anaesthesia, especially in the elderly, and the previously reported incidence of concomitant hernias.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/3. life threatening iatrogenic major vascular injuries complicating groin hernia repair.Major vascular injuries complicating groin hernia repairs are very rare. Five such cases seen at the vascular unit of the Department of Surgery, UNTH, Enugu, nigeria over a five year period are presented. The patients all of whom were adults (age range 49-65) had initial problems of hypovolaemia due to massive blood loss followed by infection and anaemia. One of the patients died from irreversible shock while still in the Casualty Unit. The vascular injuries were dealt with by either primary repair, vein graft or dacron graft depending on the prevailing conditions e.g. presence or absence of infection. The other 4 patients who had surgery did well postoperatively and on 5 to 58 months follow-up. Emphasis is laid on the underlying causes of these iatrogenic injuries which include inexperience on the part of the operator and inadequate anaesthesia (often wrongly applied local anaesthesia). If this complication however occurs, the wound should be tightly packed and patient sent immediately to a unit with vascular surgical facilities.- - - - - - - - - - ranking = 0.33333333333333keywords = anaesthesia (Clic here for more details about this article) |
3/3. Continuous spinal anaesthesia in acute respiratory failure.A patient with an obstructed femoral hernia and intercurrent respiratory failure was successfully anaesthetised with a continuous spinal technique. The technique provided excellent intra-operative anaesthesia and early postoperative analgesia, whilst avoiding further respiratory compromise. Disconnection of the catheter hub from the catheter prevented prolonged provision of postoperative analgesia by this route. Fixing of both the catheter and the hub to the patient are advocated to avoid this problem.- - - - - - - - - - ranking = 0.83333333333333keywords = anaesthesia (Clic here for more details about this article) |