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硬膜外麻醉与全身麻醉下腹腔镜完全腹膜外腹股沟疝修补术

Laparoscopic Total Extraperitoneal Inguinal Hernia Repair Under Epidural Anesthesia Versus General Anesthesia.

作者信息

Sürek Ahmet, Bozkurt Mehmet Abdussamet, Ferahman Sina, Gemici Eyüp, Dönmez Turgut

机构信息

General Surgery Department, Bakirköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.

出版信息

Surg Laparosc Endosc Percutan Tech. 2020 Oct;30(5):471-475. doi: 10.1097/SLE.0000000000000817.

Abstract

INTRODUCTION

Laparoscopic total extraperitoneal (TEP) inguinal hernia repair is a well-known approach to inguinal hernia repair. The present study aims to compare the advantages and disadvantages of the TEP technique under general anesthesia (GA) and epidural anesthesia (EA).

MATERIALS AND METHODS

The patients were divided into 2 groups as those undergoing TEP under EA (Group 1) and those undergoing TEP under GA (Group 2). The 2 patient groups were compared in terms of sex, age, body mass index data, duration of surgery, total operation time, patient satisfaction, VAS scores (1, 4, 12, and 24 h), length of hospital stay, and postoperative complications.

RESULTS

The number of patients operated under EA (Group 1) was 30, and the number of patients operated under GA (Group 2) was 32. Only in the postoperative first hour VAS scores was statistically significantly less and the need for analgesia evaluated in both groups was found to be statistically significantly lower in Group 1 (P<0.001). The mean operation time was recorded as 62 and 46.50 minutes in Groups 1 and 2, respectively, which was statistically significantly shorter in Group 2 (P<0.001). There was no difference between the 2 groups regarding complications, hospital stay, recovery, or surgery time. Conversion rate is 0 in both groups.

CONCLUSIONS

Lower postoperative VAS scores and lower postoperative VAS scores and lower analgesic used requirements of EA, it is thought that EA can be safely applied in the TEP procedure as an alternative in patients who cannot be administered GA.

摘要

引言

腹腔镜完全腹膜外(TEP)腹股沟疝修补术是一种广为人知的腹股沟疝修补方法。本研究旨在比较全身麻醉(GA)和硬膜外麻醉(EA)下TEP技术的优缺点。

材料与方法

将患者分为两组,一组在EA下接受TEP手术(第1组),另一组在GA下接受TEP手术(第2组)。比较两组患者的性别、年龄、体重指数数据、手术持续时间、总手术时间、患者满意度、视觉模拟评分(VAS)(1、4、12和24小时)、住院时间和术后并发症。

结果

在EA下手术的患者(第1组)有30例,在GA下手术的患者(第2组)有32例。仅在术后第一小时,第1组的VAS评分在统计学上显著更低,且两组评估的镇痛需求在第1组中在统计学上显著更低(P<0.001)。第1组和第2组的平均手术时间分别记录为62分钟和46.50分钟,第2组在统计学上显著更短(P<0.001)。两组在并发症、住院时间、恢复情况或手术时间方面无差异。两组的中转率均为0。

结论

EA术后VAS评分更低且术后镇痛药物使用需求更低,认为在无法实施GA的患者中,EA可作为TEP手术的一种安全替代方法。

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