Procedimentos cirúrgicos em pacientes proctológicos selecionados, sob anestesia local: estudo de 150 casos

Abstract

Experience in the treatment of 150 patients with anorectal disorders and disorders of the sacrococcygeal region who were operated on with local anesthesia at the University Hospital, ABC Medical School, São Bernardo do Campo, SP, Brazil, from March 1995 to March 1998. The anesthesia technique, the operations carried out and the tolerance to the procedure are reported. Intraoperative morbidity was 10.6% (16 patients), and postoperative morbidity was 6% (nine patients). The age of patients was between 15 and 92 years old, with mean age 42 years old; 58% of patients were male and 42% female. Surgical mean time was 45 minutes and the patients remained in the hospital for a mean time of 8 hours. All of patients was instructed about the anesthesia technique, their advantages and disadvantages, and only with their permit the surgery was programmed. Hospitalization was required in five patients (3.3%). The anesthesia technique employed was the same for all patients. Upon survey, 96.7% of the patients stated they did not feel pain during the surgery and that they would go through the procedure again. The authors conclude the surgical treatment of anorectal disorders and disorders of the sacrococcygeal region with local anesthesia is viable and safe, and in addition, is well accepted by the patients.

Análise de custos entre a raquianestesia e a anestesia venosa com propofol associada ao bloqueio perianal local em operações anorretais

“…A literatura brasileira apresenta muitos trabalhos interessantes demonstrando os benefícios das operações anorretais ambulatoriais 4,7,8,12,15 . Entretanto, apenas dois estudos salientam a redução dos custos relacionados a estes procedimentos 8,15 .…”

Cost-effectiveness analysis on spinal anesthesia versus local anesthesia plus sedation for loop colostomy closure

“…This is not a serious problem if the alternatives compared involve technologies or procedures that are relatively simple. There are examples of other studies that have proceeded in this manner, with good results and apt papers (3,8,12,13,19,20,24) . Direct costs result from interventions, and the present study was developed with this focus.…”

Influência da técnica de anestesia no tempo de ocupação de sala cirúrgica nas operações anorretais

“…Há constante preocupação da literatura médica sobre a seleção de pacientes que possam ser candidatos à realização de procedimentos anorretais ambulatoriais [11][12] . Uma análise de 3725 pacientes operados em regime ambulatorial publicada em 2000 por Roche e Marti mostra que cerca de 70% dos pacientes puderam ser anestesiados com bloqueio local 13 .…”

“…Este trabalho não analisou o grau de satisfação dos pacientes com as diferentes técnicas de anestesia. Entretanto, alguns estudos na literatura evidenciam que a maioria dos pacientes aprova o procedimento ambulatorial, principalmente com anestesia venosa associada ao bloqueio local, e repetiriam o procedimento outras vezes, se necessário fosse 12,16 . O benefício de não sentir dor durante a aplicação do anestésico local pela hipnose da anestesia venosa é a grande vantagem relatada deste método de anestesia combinada.…”