Pediatric Inguinal Hernia Surgery 2,230 Cases Performed with Ketamine and Lidocaine

Jongsoo Joo, H. Joo, I. H. Joo
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Abstract

Ketamine is a safe and effective drug for pediatric anesthesia, sedation and analgesia. We hoped to identify that surgeons could operate a pediatric hernia with the ketamine anesthesia without general anesthesia. The study was a consecutive case series of 2230 inguinal hernia patients aged 1 months to 17 years in a Joo's day-surgical clinic during 11-year period. The patients had pediatric inguinal hernia surgery without general anesthesia under the day-surgery system. We retrospectively analyzed the medical record of patients who were registered with the Diagnosis Related Group (DRG) system. All patients received ketamine (5 mg/kg) and atropine (0.01 mg/kg) intramuscularly before surgery. After anesthesia, we injected 1~2 % lidocaine (Less than 5 ml) subcutaneously at the site of incision and started operation. The surgical method was the high ligation method of the hernia sac.) In total 2230 patients, male were 1756 and female were 474. 2076 patients were a unilateral inguinal hernia at the time of surgery and 154 were bilateral hernia patients. Less than three months, depending on the age of the patients was 391, and less than 12 months the patient was 592 people (26.5 %). After surgery, there were no accidents or long term complications associated with ketamine anesthesia. We think the surgeon can safely do the pediatric inguinal hernia surgery using ketamine and lidocaine without anesthesiologist through 11 years of our surgical experiences.
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小儿腹股沟疝手术应用氯胺酮和利多卡因2230例
氯胺酮是一种安全有效的小儿麻醉、镇静、镇痛药物。我们希望确定外科医生可以在没有全身麻醉的情况下使用氯胺酮麻醉进行小儿疝气手术。该研究是对2230例年龄在1个月至17岁之间的腹股沟疝患者在11年期间的连续病例系列研究。患儿在日间手术系统下行小儿腹股沟疝手术,无全身麻醉。我们回顾性分析了在诊断相关组(DRG)系统登记的患者的病历。所有患者术前肌注氯胺酮(5mg /kg)和阿托品(0.01 mg/kg)。麻醉后,在切口皮下注射1~ 2%利多卡因(小于5 ml),开始手术。手术方法为疝囊高位结扎法。共2230例,其中男性1756例,女性474例。手术时单侧腹股沟疝2076例,双侧腹股沟疝154例。根据患者的年龄,小于3个月的患者为391人,小于12个月的患者为592人(26.5%)。手术后,氯胺酮麻醉没有发生意外或长期并发症。通过我们11年的手术经验,我们认为外科医生可以在没有麻醉师的情况下安全地使用氯胺酮和利多卡因进行小儿腹股沟疝手术。
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