Ciaccia E, Silla R, Coan A
Reparto di Chirurgia Generale e Videochirurgia, Unità Operativa di Day Surgery - Centro Ernie, Ospedale San Camillo, Treviso, Italy.
Minerva Chir. 2008 Feb;63(1):1-8.
The aim of this paper is to compare local, spinal and general anesthesia with the tolerance of the patients as to pain and quality of life in the immediate postoperative period, and in the first week after the operation of prosthetic inguinal hernioplastics.
Three hundred and fifty eight patients underwent inguinal hernioplastes in day surgery regimen. The patients were divided into three groups according to the type of anesthesia and with the help of a schedule given to them. The parameters of the immediate postoperative period, such as pain nausea, vomit, cephalalgia, diuresis and the parameters in the following seven days after the operation, such as mobility, activity, pain, dejection and analgesic therapy, were compared.
Collected data put into evidence a significative value, the mean pain value in the postoperative period, calculated on a numeric scale comprising numbers from 1 to 10. In patients who underwent a surgical procedure after a local anesthesia the mean pain value was 3.1. Comparison of postoperative symptoms highlights an asymptomatic condition in local or spinal anesthesia operated patients. Local anesthesia is generally more painful in the perioperative stage. Local anesthesia operated patients lament a longer duration of pain, in days, in the postoperative period and a longer administration of analgesics. No significance difference between mobility and quality of life has been noticed.
The results of our study demonstrate that the comparison among the three types of anesthesia operated in day surgery is well balanced, as it was clearly expressed by the patients of each group. Every group was satisfied with its own anesthesia protocol.
本文旨在比较局部麻醉、脊髓麻醉和全身麻醉对接受人工腹股沟疝修补术患者术后即刻及术后第一周疼痛耐受性和生活质量的影响。
358例患者在日间手术方案下接受腹股沟疝修补术。根据麻醉类型并借助给予他们的一份时间表将患者分为三组。比较术后即刻的参数,如疼痛、恶心、呕吐、头痛、利尿情况,以及术后七天内的参数,如活动能力、活动情况、疼痛、沮丧情绪和镇痛治疗情况。
收集的数据显示出显著价值,即术后时期的平均疼痛值,采用包含1至10数字的数字评分量表计算。接受局部麻醉后进行手术的患者平均疼痛值为3.1。术后症状比较突出了接受局部或脊髓麻醉手术患者的无症状状态。局部麻醉在围手术期通常更疼痛。接受局部麻醉手术的患者抱怨术后疼痛持续天数更长,镇痛药物使用时间更长。在活动能力和生活质量方面未发现显著差异。
我们的研究结果表明,日间手术中三种麻醉方式的比较是相当平衡的,正如每组患者所明确表达的那样。每组患者对其自身的麻醉方案都感到满意。