N J Jebbin1. 1. Department Of Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
Abstract
BACKGROUND: Appendicectomy canb-be performed under general, regional and local anaesthesia but the anaesthetic risks are least with the later. Where it is appropriate to perform a procedure under local anaesthesia therefore, this method should be readily utilized. This report aims to share one surgeon's experience with local anaesthesia for appendicectomy. METHOD: A prospective study was carried out at the Mile One Hospital, a private clinic in Port Harcourt, Nigeria. Patients with acute appendicitis admitted for appendicectomy between July 1999 and December 2002 were assessed and recruited into the study based on criteria such as weight less than 70 kg and option for local anaesthesia. Lignocaine (0.5%) in a dose of 3-4 mg/kg body weight was infiltrated in the line of incision (Lanz) superficially and then into deeper planes. Those who would not tolerate lignocaine alone were sedated with 10 mg of diazepam and 30 mg of pentazocine. Patients who still would not tolerate the procedure were converted to general anaesthesia with ketamine. The appendix was removed with the stump unburied. CONCLUSION: Appendicectomy under local anaesthesia is safe and effective. It is recommended where modem anaesthetic equipment or trained anaesthetists are not available (such as rural areas).
BACKGROUND: Appendicectomy canb-be performed under general, regional and local anaesthesia but the anaesthetic risks are least with the later. Where it is appropriate to perform a procedure under local anaesthesia therefore, this method should be readily utilized. This report aims to share one surgeon's experience with local anaesthesia for appendicectomy. METHOD: A prospective study was carried out at the Mile One Hospital, a private clinic in Port Harcourt, Nigeria. Patients with acute appendicitis admitted for appendicectomy between July 1999 and December 2002 were assessed and recruited into the study based on criteria such as weight less than 70 kg and option for local anaesthesia. Lignocaine (0.5%) in a dose of 3-4 mg/kg body weight was infiltrated in the line of incision (Lanz) superficially and then into deeper planes. Those who would not tolerate lignocaine alone were sedated with 10 mg of diazepam and 30 mg of pentazocine. Patients who still would not tolerate the procedure were converted to general anaesthesia with ketamine. The appendix was removed with the stump unburied. CONCLUSION: Appendicectomy under local anaesthesia is safe and effective. It is recommended where modem anaesthetic equipment or trained anaesthetists are not available (such as rural areas).