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2022, Número 3

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Revista Cubana de Cirugía 2022; 61 (3)


Anestesia local para la cirugía de la hernia inguinal entre la evidencia y la experiencia

Adefna PRI, Poviones CJ, Izquierdo LFT

Idioma: Español
Referencias bibliográficas: 56
Paginas: 1-22
Archivo PDF: 660.46 Kb.


RESUMEN

Introducción: La cirugía de la hernia inguinal constituye uno de los procederes más comunes a nivel mundial. Se estima que el 80 % son realizados con anestesia regional o general, y un 20 % con local en contra de la recomendación de las sociedades internacionales que aceptan que la mayor parte de los enfermos son candidatos para este método.
Objetivos: Describir la técnica de anestésica local aplicada por el propio cirujano, exponiendo sus ventajas y desventajas apoyadas en la evidencia relevante disponible.
Métodos: Se realizó una revisión híbrida de tipo narrativa. Se describió el método anestésico empleado por nuestro grupo. Paralelamente, se realizó una búsqueda en las principales bases de datos para la identificación de las investigaciones que sostienen y defienden los aspectos técnicos y decisiones clínicas tomadas.
Desarrollo: No existen contraindicaciones absolutas para la selección de la anestesia local, en su mayoría son relativas. El anestésico a emplear es lidocaína, aunque adjuvantes pueden ser tenidos en cuenta. La sedación pre o transoperatoria no se recomienda. El método anestésico involucra la fase subcutánea con una técnica de bloqueo de campo y fase incisional profunda con infiltración tumescente.
Conclusiones: El empleo de anestesia local para la cirugía de hernia inguinal por vía anterior puede ser considerado de primera elección. Es más económica y las complicaciones urinarias y cardiovasculares se reducen. Para lograr una cirugía de igual calidad a otro método de anestesia es importante dominar la técnica anestésica.


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