By Asadolah Saadatniaki
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Example text
Those who prefer general or regional anesthesia and patients with adverse reactions to LA should be excluded, as well as patients with psychological and psiquiatric conditions. An experienced surgeon in the use of local anesthesia will not only perform a better anesthesia but will positively influence his patient during the intervention. The surgeon-patient relationship is relevant in these cases. The surgeon should be experienced in the management of the abdominal wall in order to realize a technically adequate procedure in a short time, with a careful and delicate management of tissues.
This can potentially decrease the cost and lessen the burden on the operating room and recovery room. Some of the standard procedures currently being done include transrectal guided biopsy, flexible cystoscopy, percutaneous nephrostomy, percutaneous cyst aspiration, renal biopsy, and various scrotal procedures. Some of the other procedures that are being done include optical urethrotomy, rigid cystoscopy, bladder biopsy, ureteroscopy, transurethral incision and resection of the prostate, ureteral meatotomy, and resection of primary and recurrent bladder tumors.
48 Clinical Use of Local Anesthetics A new tool of using the diode laser to treat urethral strictures has been proposed, which was tolerated by only 3 out of 22 patients under local anesthesia. The rest were operated on under general or spinal anesthesia (Kamal, 2001). The procedure has been advocated as a first line treatment. Another method of local anesthesia, the transperineal urethrosphincteric block using 1% lidocaine showed favorable results in treating anterior urethral strictures, with 92% patients very satisfied with the procedure.