Monitored anesthesia care for unilateral inguinal herniorrhaphy in high risk patients: Two cases report

Kim, Min Sung; Lee, Jong Yeon; Bang, Yun Sic; Shin, In Ho; Park, Chung Hyun; Chun, Duk Hee; Yang, Hyeon Jeong

Case Report

Anesthetic Pharmacology

Anesthesia and Pain Medicine 2011;6(3):240-243.
Published online July 30, 2011.

Monitored anesthesia care for unilateral inguinal herniorrhaphy in high risk patients: Two cases report

Min Sung Kim, Jong Yeon Lee, Yun Sic Bang, In Ho Shin, Chung Hyun Park, Duk Hee Chun, Hyeon Jeong Yang

Department of Anesthesiology and Pain Medicine, School of Medicine, CHA University, Seongnam, Korea. anesthpark@cha.ac.kr

Abstract

Remifentanil, an ultra-short acting opioid, exhibits at low doses distinct sedative properties that may be useful for supplementation of regional or local anesthesia. We described two patients suffered from serious underlying medical problems who underwent unilateral inguinal herniorrhaphy. One of them was 61 year-old male patient who had type B viral hepatitis, Child class B liver cirrhosis and rheumatoid arthritis with severe joint deformity including instability of cervical vertebrae. The other patient was 73 year-old man who had severe coronary artery occlusive disease which was recently managed with coronary stent and was underwent hemodialysis three times a week due to chronic renal failure. Monitored anesthesia care (MAC) with remifentanil through target controlled infusion (TCI) and local infiltration and ilioinguinal-hypogastric nerve block (IHNB) were done for herniorrhaphy. The operations were performed successfully without any complications such as respiratory depression or hypoxia and all patients and surgeon were very satisfied with MAC.

Key Words: Inguinal herniorrhaphy, Monitored anesthesia care, Remifentanil