Zaballos M, López-Álvarez S, Zaballos-Bustingorri J, Rebollo-Laserna F, de la Pinta-García J C, Monzó-Abad E
Departamento de Anestesia, Hospital Universitario Gregorio Marañón, Profesor asociado, Departamento de Toxicología y Legislación Sanitaria, Universidad Complutense, Madrid, España.
Rev Esp Anestesiol Reanim. 2012 Jan;59(1):18-24. doi: 10.1016/j.redar.2011.11.001. Epub 2012 Mar 14.
Despite renewed interest in the management of anaesthesia during inguinal hernia surgery, there is a lack of data on trends in anaesthesia in Spain. The purpose of this study was to analyse the different anaesthetic techniques used in inguinal hernia surgery and their association with recovery, hospital stay, complications, and satisfaction with the technique.
Ours was a multicentre, descriptive, cross-sectional epidemiological study performed at 20 Spanish hospitals. Each centre included 12 patients who underwent elective inguinal hernia repair. Data were collected on patient characteristics, clinical history, anaesthetic technique, post-operative recovery, and complications.
Data were collected on 238 patients, most of whom (91%) were ASA I or II, with a mean age of 57 years (25-84). Day surgery was performed in 47% of cases; 26% as one-day surgery, and the rest as inpatient surgery. Spinal anaesthesia was the most widely used technique (60%), followed by general anaesthesia (27%), and local anaesthesia with sedation (13%) (pP<.0001). Discharge was within 6 hours with general anaesthesia and local anaesthesia in 94% and 100% of cases, respectively, compared with 68% for spinal anaesthesia (001). No differences were observed between anaesthetic techniques in terms of adverse effects, except for urinary retention in 10 male patients (mean age 68 years) all of whom had received spinal anaesthesia.
Spinal anaesthesia is the most commonly used technique in Spain for inguinal hernia repair, although it is associated with a longer hospital stay (greater than 6h in 32% of cases) and a high incidence of urinary retention than other anaesthetic methods, in particular those with local infiltration. These techniques should be more vigorously implemented in daily practice.
尽管腹股沟疝手术麻醉管理再次受到关注，但西班牙缺乏麻醉趋势的数据。本研究的目的是分析腹股沟疝手术中使用的不同麻醉技术及其与恢复、住院时间、并发症和技术满意度的关系。
我们在20家西班牙医院进行了一项多中心、描述性、横断面流行病学研究。每个中心纳入12例接受择期腹股沟疝修补术的患者。收集了患者特征、临床病史、麻醉技术、术后恢复和并发症的数据。
收集了238例患者的数据，其中大多数（91%）为美国麻醉医师协会（ASA）I或II级，平均年龄57岁（25 - 84岁）。47%的病例进行了日间手术；26%为一日手术，其余为住院手术。脊髓麻醉是使用最广泛的技术（60%），其次是全身麻醉（27%）和局部麻醉加镇静（13%）（p<0.0001）。全身麻醉和局部麻醉分别在94%和100%的病例中6小时内出院，而脊髓麻醉为68%（p<0.001）。除10例男性患者（平均年龄68岁）出现尿潴留外，各麻醉技术在不良反应方面未观察到差异，所有这些患者均接受了脊髓麻醉。
在西班牙，脊髓麻醉是腹股沟疝修补术最常用的技术，尽管与其他麻醉方法相比，尤其是局部浸润麻醉，它与更长的住院时间（32%的病例超过6小时）和高尿潴留发生率相关。这些技术应在日常实践中更积极地应用。
