Mishina T, Aiba T, Hiramatsu K, Shibata Y, Yoshihara M, Aoba T, Yamaguchi N, Kato T
Department of General Surgery, Toyohashi Municipal Hospital, Toyohashi, Japan.
Department of Surgery, Ogaki Municipal Hospital, Ogaki, Japan.
Hernia. 2018 Jun;22(3):471-478. doi: 10.1007/s10029-017-1680-1. Epub 2017 Sep 30.
In Japan, inguinal hernia repair is widely performed with local anesthesia. The objective of this study was to evaluate safety and efficacy of intravenous dexmedetomidine as a sedation agent with local anesthesia in inguinal hernia repair.
We performed this randomized, single-blind study for 200 patients who were scheduled to undergo inguinal hernia repair with local anesthesia. Patients were randomly divided into two groups (dexmedetomidine group: Group D, midazolam group: Group M). The primary outcome was to evaluate the safety of intravenous dexmedetomidine. Secondary outcomes were to analyze results of operators' surveys and patients' questionnaires and evaluate implementation of conscious sedation.
Incidence of respiratory depression was significantly higher in Group M than Group D (p = 0.03). Other adverse events examined did not differ significantly. All three operators' questionnaires indicated that results were better in Group D than Group M. More than 70% of patients in both groups were satisfied with the surgery. More than 80% of Group D patients and 74% of Group M patients achieved a state of conscious sedation.
This study demonstrated that intravenous dexmedetomidine during hernia repair with local anesthesia is safe and the results were satisfactory to both operators and patients.
在日本，腹股沟疝修补术广泛采用局部麻醉进行。本研究的目的是评估静脉注射右美托咪定作为局部麻醉下腹股沟疝修补术中镇静剂的安全性和有效性。
我们对200例计划接受局部麻醉下腹股沟疝修补术的患者进行了这项随机、单盲研究。患者被随机分为两组（右美托咪定组：D组，咪达唑仑组：M组）。主要结局是评估静脉注射右美托咪定的安全性。次要结局是分析术者调查结果和患者问卷，并评估清醒镇静的实施情况。
M组呼吸抑制的发生率显著高于D组（p = 0.03）。所检查的其他不良事件无显著差异。所有三份术者问卷均表明，D组的结果优于M组。两组中超过70%的患者对手术满意。D组超过80%的患者和M组74%的患者达到了清醒镇静状态。
本研究表明，局部麻醉下疝修补术中静脉注射右美托咪定是安全的，且术者和患者对结果均满意。
