Analgesia-sedation for day-case inguinal hernia repair - A review of patient acceptance and morbidity

The objective of this study was to determine whether analgesia-sedation imp roved patient acceptance of day-case herniorrhaphy and to evaluate the exte nt of patient morbidity. A total of 98 patients (mean age 34 years, range 1 7-75 years) were studied before and after herniorrhaphy to determine their response to the procedure. All patients were unpremedicated and underwent h erniorrhaphy using a Bassini repair technique with a standard local anaesth etic block. Sedation wets obtained with titrated intravenous midazolam (Hyp novel, Roche Products Ltd) without narcotic analgesia. Patients were evalua ted with a simple questionnaire after surgery. The maximum dose of midazola m used was 5 mg (median dose 3.5 mg). Monitoring of vital signs with pulse oximetry during the operative period was routine though oxygen therapy was not required. All patients were able to walk without assistance and were di scharged under responsible supervision. Operative morbidity was low (5%). A dverse reactions to the procedure such as nausea, vomiting and headache wer e not seen. In conclusion, conscious sedation allows amnesia to be achieved with low morbidity in the majority of patients undergoing local anaestheti c procedures. This should result in increased patient acceptance.