title: [Eighty cases of monitored anesthesia care (MAC) for inguinal hernia repairs using tumescent local anesthesia (TLA)].
abstract: BACKGROUND
  This paper discusses the efficacy and difficulty of the management of monitored anesthesia care (MAC) for inguinal hernia repairs using tumescent local anesthesia(TLA).
  
  
  METHODS
  Eighty patients were retrospectively divided into four groups (all n = 20) according to the drugs used; group P (propofol), group PF (propofol and fentanyl), group PFM (propofol, fentanyl and midazolam), group PR (propofol and remifentanyl). The four groups were analyzed in terms of the applied dose, airway use, wake-up test to determine whether hernia was repaired, postoperative pain and nausea.
  
  
  RESULTS
  More propofol was administered in group P than in group PFM and PR. Although, airway was used for nine patients, there was no difference between the four groups. Postoperative pain and nausea also do not differ between the groups. One patient in group P showed unsuccessful repair with wake-up test.
  
  
  CONCLUSIONS
  MAC shows a beneficial effect on inguinal hernia repairs under TLA. The rate of airway use was as high as eleven percent, and maintenance of the patients' airway requires attention. In terms of wake-up test, propofol combined with opioid administration may be more effective than propofol administration alone. There was no significant difference between the groups in pain and nausea, regardless at the use of fentanyl or remifentanil.
authors: Department of Anesthesiology, Tohoku Rosai Hospital, Sendai 981-8563.
authors: Koko
authors: K
authors: Adachi
authors: Eri
authors: E
authors: Kameyama
authors: Masahiro
authors: M
authors: Yamada
authors: Tadaho
authors: T
authors: Nakamura
authors: Kentaroh
authors: K
authors: Uchida
authors: Tomoko
authors: T
authors: Hayasaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D005260:Female; D005283:Fentanyl; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008874:Midazolam; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D010149:Postoperative Pain; D010880:Piperidines; D020250:Postoperative Nausea and Vomiting; D015742:Propofol; D000077208:Remifentanil; D012189:Retrospective Studies
chemical_list: D010880:Piperidines; D000077208:Remifentanil; D008874:Midazolam; D005283:Fentanyl; D015742:Propofol