Edin Begić, Nedim Begić, Amra Dobrača 37th IMSC - International Medical Scientific Congress for students and young doctors 10-13 May 2014, Ohrid, Macedonia JUSTIFICATION OF SPINAL ANESTHESIA IN THE OPERATIVE TREATMENT OF INGUINAL HERNIA Edin Begić, Nedim Begić, Amra Dobrača University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina

Spinal anesthesia is the fastest and most reliable form of central neuraxial anesthesia.

Injection of local anesthetic into the subarachnoid space occurs return nervous block of front and rear of the roots, which leads to loss of autonomic, sensory and motor activities.

Local anesthetics for spinal anesthesia are classified as hypo-, iso-and hyperbaric. Hypobaric solutions gravitate upwards. Isobaric solutions remain at the injection site. Hyperbaric solutions move depending on the location in the spinal subarachnoid space.

Local anesthetics which are most often used are lidocaine, bupivacaine and tetracaine. Duration of spinal anesthesia depends on the age, the selection of the local anesthetic, dose, concentration and baricity of local anesthetics and additives used with local anesthetics (epinephrin).

It is ideal for lower abdominal, pelvic, perineal and lower extremity surgery. The most common side effects are headache, nausea, vomiting, hiccups, hypotension and bradycardia. It can also lead to a decrease in body temperature as a result of sympathetic blockade and associated vasodilation.

Also in the early postoperative period it may cause urinary retention, post-lumbar puncture headache, low back pain, and transient neurological complications. Patients may be asked to stop taking any drugs that make it hard for their blood to clot 7 - 10 days before the procedure. Some of these are aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), warfarin (Coumadin), naproxen (Aleve, Naprosyn), and heparin.

A hernia is a protrusion of any viscus (or part of it) through normal or abnormal opening in a cavity. An inguinal hernia occurs when soft tissue — usually part of the membrane lining the abdominal cavity (omentum) or part of the intestine — protrudes through a weak point in the abdominal muscles

MATHERIALS AND METHODS Purpose of study was to show the justification of the use of spinal anesthesia in the operative treatment of inguinal hernia.

MATHERIALS AND METHODS The study was conducted on 25 patients (over a period of eight months) in whom spinal anesthesia is administered due to the surgical treatment of inguinal hernia. The study had a clinical, prospective, descriptive and analytical character.

RESULTS Spinal anesthesia was performed with 27 G needle ​(0.41 mm), with 0.5% bupivacaine in dose of 15-20 mg. From the studied patients, 25 (100%) were male.

RESULTS Tension value is continuously recorded, and in 4 (16%) patients a decline of tension (systolic blood pressure below 90mmHg) was recorded after 10 minutes. The pulse ranged between 60-80 bpm in all patients.

In 3 (12%) patients spinal block wasn’t complete and it was necessary to introduce the patient into general anesthesia (propofol + fentanyl).

After 12 hours 1 (4%) patient complained about headache and vomiting. At the injection site in 2 (8%) patients appeared redness, without infectious process.

CONCLUSION As a unique anesthetic technique, spinal anesthesia is the fastest and most reliable method of regional anesthesia, with a high degree of success and rare complications.

CONCLUSION Such a technique is a good choice for the surgical treatment of inguinal hernia.

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