Inguinal hernioraphy under local anesthesia in the elderly patients

Yıl 2012, Cilt: 39 Sayı: 4, 513 - 517, 01.12.2012

Nurettin Kahramansoy Oktay Büyükaşık Hayri Erkol Cavit Çöl

https://doi.org/10.5798/diclemedj.0921.2012.04.0192

Öz

Objectives: The incidence of inguinal hernia and the frequency of comorbidity increase in the elderly. Therefore, in operations of these patients, anesthesia methods are important. The aim of our study was to investigate the feasibility of local anesthesia in the operation of the elderly. Materials and methods: The patients operated for inguinal hernia were analyzed retrospectively. They were divided into two groups: the elderly (>60 years) and the younger. Anesthesia methods, additional anesthesia requirement and complications were compared. Results: Of totally 177 patients, 30.5% were elderly. Operation type, anesthesia method and score of operational risk differed between groups. The percentage of co morbidity (55.6%) in the elderly was significantly high (p< 0.001). Among elderly, the frequency of co morbidity was slightly higher in patients who had local anesthesia compared to spinal and general anesthesia. Patients in young and middle ages preferred to be operated less under local anesthesia (34.1%) compared to elderly (70.4%). There was one case (2.6%) converted to general anesthesia as an additional anesthesia in the elderly group. Postoperative complications were slight more frequent in elderly. These cases were five in number (31.3%) and were operated under spinal or general anesthesia (p=0.002). Conclusions: The frequency of co morbidity and risk score of operation (ASA category) rise in the elderly. However, inguinal hernioraphy can be performed under local anesthesia without complication and conversion to general anesthesia.

Anahtar Kelimeler

Inguinal hernia; aged; comorbidity; local anesthesia

İleri yaş hastalarda lokal anestezi altında kasık fıtığı tamiri

Öz

Amaç: Yaş ilerledikçe inguinal hernilerin görülme sıklığı ve yandaş hastalık oranı artmaktadır. Bu nedenle ileri yaştaki hastalarda herniorafi sırasındaki anestezi yöntemi önem taşımaktadır. Çalışmamızın amacı, yaşlı hastaların operasyonunda lokal anestezinin uygulanabilirliğini araştırmaktı. Gereç ve yöntem: İnguinal herni tanısı ile opere edilen hastalar retrospektif olarak incelendi. Hastalar, ileri yaşlılar (>60) ve daha gençler olarak iki gruba ayrıldı. Uygulanan anestezi yöntemleri, ek anestezi gereksinimi ve komplikasyonlar karşılaştırıldı. Bulgular: Toplam 177 hastanın %30,5\'i yaşlı idi. İki grup arasında operasyon tipi, anestezi yöntemi ve operasyon risk skoru belirgin farklılık gösterdi. Yaşlı olgularda, yandaş hastalık oranı (%55,6) belirgin yüksek (p< 0,001) idi. Yaşlı olgular arasında, lokal anestezi uygulanan olguların spinal-genel anestezi uygulananlara göre yandaş hastalık oranı hafif yüksekti. Lokal anesteziyi tercih oranı, genç-orta yaş olgularda %34,1 iken yaşlı olgularda %70,4 idi. Lokal anestezi yapılan ileri yaştaki bir olguda (%2,6) genel anesteziye dönüş oldu. Postoperatif komplikasyona, ileri yaşta daha sık rastlandı. İleri yaştaki komplikasyon gözlenen beş olgu (%31,3), genel-spinal anestezi yapılan olgular idi (p=0,002). Sonuç: İleri yaş hastalarda yandaş hastalık oranı ve operasyon risk skoru (ASA kategorisi) yükselmektedir. Lokal anestezi altında inguinal herniorafi, komplikasyonsuz ve genel anesteziye dönüş olmadan yapılabilir.

Anahtar Kelimeler

İnguinal fıtık, yaşlı, yandaş hastalık, lokal anestezi

Kaynakça

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