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Biomedical subjects

F H Andersen

Publications and source records attributed to F H Andersen.

7 recordsLinked to original sources
PubMed2005

Combined ilioinguinal blockade and local infiltration anaesthesia for groin hernia repair--a double-blind randomized study.

BACKGROUND: Local infiltration anaesthesia for inguinal hernia repair is cost-effective, but fear of intra-operative pain may hinder its widespread use. It is unknown whether a combined ilioinguinal blockade and local infiltration anaesthesia improves intra-operative analgesia. METHODS: We performed a double-blind randomized study in 160 patients undergoing inguinal hernia mesh repair under local infiltration anaesthesia with or without additional ilioinguinal blockade. Intra-operative pain and pain at 24 and 48 h postoperatively and analgesic requirements (acetaminophen, ibuprofen, and tramadol) were assessed. RESULTS: Median intra-operative pain scores were reduced (P=0.02) from 13 to 9 with additional ilioinguinal blockade, with no differences in requirement for sedation. There were significantly (P<0.05) more patients with intra-operative visual analogue pain scale >/=30 in the placebo group vs the ilioinguinal blockade group. Postoperative pain scores and analgesic requirements were similar. CONCLUSION: Combined ilioinguinal blockade and local infiltration anaesthesia is recommended for groin hernia repair to reduce intra-operative pain.

Adult↗
PubMed2001

Quality assessment of 26,304 herniorrhaphies in Denmark: a prospective nationwide study.

BACKGROUND: Groin hernia repair is one of the most frequent operations, but there is no consensus about surgical or anaesthetic technique. Furthermore, no nationwide studies have been done. Our aim was to investigate outcome results of groin hernia surgery to improve quality of treatment. METHODS: We prospectively recorded 26304 groin hernia repairs done in Denmark from Jan 1, 1998, to June 30, 2000, in a nationwide Danish hernia database. FINDINGS: 93% of all groin herniorrhaphies done in Denmark in the 30 months of the study were recorded in the database. Kaplan-Meier estimates of reoperation rates 30 months after anterior mesh repair and laparoscopic repair were significantly lower than after sutured posterior wall repairs in primary inguinal hernia (2.2% and 2.6% vs 4.4%; p<0.0001). Reoperation rates were also lower with anterior mesh repair (6.1%; p<0.0001) and laparoscopic repair (3.4%; p<0.0001) than with sutured posterior wall repair (10.6%) after recurrent hernia. Use of Lichtenstein mesh repair increased from 33% in January, 1998, to 62% in June, 2000, whereas use of laparoscopic repair remained constant at about 5%. Kaplan-Meier estimates of reoperation rates were 2.8% in the first 15 months and 1.6% in the second (p=0.03). For elective repairs, only 59% of patients were treated on an outpatient basis, and only 18% had local anaesthesia. INTERPRETATION: Mesh repairs have a lower reoperation rate than conventional open repairs. Systematic prospective recording of treatment and outcome variables in a national clinical database improved the overall quality of surgical care. However, there is a large potential for cost savings and more efficient patient care with extended use of mesh techniques, outpatient surgery, and local anaesthesia.

Adult↗
PubMed1994

[Alternatives to acute admissions to a city hospital. Is it possible to reduce the number of acute admissions?].

The purpose of the study was to evaluate the number of inappropriate admissions to a smaller city hospital and find possible alternatives. Physicians and surgeons from three units (abdominal surgery, internal medicine and orthopaedic surgery) together with general practitioners, doctors on homecall duty and health personnel from the region contributed to the study. In all 421 consecutive patients were included during a three-week period. The patients' median age was 60.5 years. It was found that at least 13.6% of all patients seemed to have been admitted for an inappropriate reason. According to the admitting doctor 3.4% of the patients were not ill at all. The investigation implies that one out of seven acute admissions could be replaced by alternatives such as immediate care in residential homes, more flexible contact to the outpatient's clinic, better access to geriatric evaluation and improved laboratory service. We conclude that acute admission to hospital can be replaced by other alternatives, thereby achieving greater efficiency and better economics.

Adult↗
PubMed1986

A long-term gastrointestinal follow-up in patients operated on for congenital hypertrophic pyloric stenosis.

A gastrointestinal follow-up of 91 patients operated on for congenital hypertrophic pyloric stenosis (CHPS) between 1942 and 1964, using the Fredet-Ramstedt method, is presented. Among 85 patients available for follow-up, 72 responded to a request for reexamination. These patients were interviewed personally by one of the authors. Thirty-four patients (47%) consented to have a Roentgen examination done, performed as a double contrast study, investigating the structure and function of the stomach and duodenum. Forty-two patients (58%) had varying minor gastrointestinal complaints. Only two patients had severe symptoms. X-ray examination in 34 patients (47%) showed only three with pathological changes, i.e. one with mild deformation of the duodenal bulb, another with slight duodenal reflux. The third X-ray showed massive gastric retention with duodenal bulb deformation. The patient suffered from severe dyspepsia and vomitus. No correlation was found between the severity of the CHPS and the presence of later gastrointestinal symptoms. It is concluded that the Fredet-Ramstedt's operation for CHPS is an efficious operation with few perioperative complications and good long-term results.

Adult↗