Gultekin F Ayca, Kurukahvecioglu Osman, Karamercan Ahmet, Ege Bahadir, Ersoy Emin, Tatlicioglu Ertan
Department of Surgery, Gazi University Faculty of Medicine, Ankara, Turkey.
Hernia. 2007 Apr;11(2):153-6. doi: 10.1007/s10029-006-0166-3. Epub 2006 Nov 29.
Today, in inguinal hernia repair, postoperative pain and costs are regarded as equally important issues as technique and recurrence rates. Postoperative pain is thought to vary according to the applied anesthesia method. As local anesthesia is reported to inflict less pain, its effects on early period post-operative complications should also be evaluated.
Two hundred patients, on whom Lichtenstein tension free hernia repair had been performed due to unilateral inguinal hernia between March 2004 and July 2005, were prospectively examined. The patients were randomized according to the anesthesia applied. They were divided into two groups: local anesthesia (LA) and spinal anesthesia (SA). The early post-operative complications, post-operative pain scores, and operation durations of the patients, were evaluated.
Local anesthesia was found not to increase the post-operative complications; on the contrary, it was shown to prevent the complications of spinal anesthesia. Although visual analogue pain score (VAS) values at 4, 8, 12, and 24 h post-operation were found to be lower than the SA group, the difference between was not significant. Also, it was discovered that LA did not retard the operation duration.
Local anesthesia reduces post-operative pain and facilitates patients' mobilization and discharge along with decreasing the early post-operative complications. Thus, LA is a safe and advantageous method to be applied in inguinal hernia repair.
如今,在腹股沟疝修补术中,术后疼痛和费用被视为与手术技术及复发率同等重要的问题。术后疼痛被认为会因所采用的麻醉方法而异。由于据报道局部麻醉引起的疼痛较小,因此也应对其对术后早期并发症的影响进行评估。
前瞻性地检查了2004年3月至2005年7月期间因单侧腹股沟疝接受利氏无张力疝修补术的患者。根据所采用的麻醉方法将患者随机分组。他们被分为两组:局部麻醉(LA)组和脊髓麻醉(SA)组。对患者的术后早期并发症、术后疼痛评分及手术时长进行了评估。
发现局部麻醉不会增加术后并发症;相反,它被证明可预防脊髓麻醉的并发症。尽管术后4、8、12和24小时的视觉模拟疼痛评分(VAS)值低于SA组,但两者之间的差异并不显著。此外,还发现局部麻醉不会延长手术时长。
局部麻醉可减轻术后疼痛,促进患者活动及出院,同时减少术后早期并发症。因此,局部麻醉是一种应用于腹股沟疝修补术的安全且有利的方法。