The American surgeon
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The American surgeon · Aug 1994
Inguinal herniorrhaphy under local anesthesia: a study of intraoperative tolerance.
Tolerance to inguinal hernia repair under local anesthesia was prospectively evaluated in a consecutive series of 41 patients who underwent hernia repair with local infiltration of 0.75 per cent lidocaine. Intraoperative discomfort was measured by an analog visual scale. All complications were also recorded. ⋯ There was no operative mortality. Normal diet was tolerated the day of surgery in 39 patients, and 30 were discharged from the hospital on the same day. Our series supports good tolerance and a low complication rate when inguinal herniorrhaphy is performed under local anesthesia.
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The American surgeon · Aug 1994
Thyroidectomy in patients with marked thyroid enlargement: airway management, morbidity, and outcome.
The medical records of 91 patients who underwent thyroidectomy from 1990 to 1993 were reviewed to evaluate airway management and operative morbidity in patients with marked thyroid enlargement. Twenty-nine patients with marked thyroid enlargement were identified: 13 unilateral, defined by a weight of > or = 40 g (mean 122 g, range 41-380 g), and 16 bilateral, defined by a weight of > or = 80 g (mean 160 g, range 82-404 g). Twenty-five patients had compressive symptomatology, 18 had tracheal narrowing and/or displacement, 19 had substernal extension, and one had superior vena cava syndrome. ⋯ Six (21%) of 29 patients had temporary hypocalcemia compared to eight (13%) of 62 patients with lesser thyroid enlargement (P = 0.36). One patient with an unresectable follicular carcinoma died from aspiration pneumonia three weeks following tracheostomy placement. Marked thyroid enlargement and upper airway compression is predominantly caused by benign disease; however, when there is associated recurrent laryngeal nerve dysfunction, carcinoma is more common.(ABSTRACT TRUNCATED AT 250 WORDS)