Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Division of General Surgery, Department of Surgery, Minimally Invasive Surgery Unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
PLoS One. 2020 Nov 30;15(11):e0242925. doi: 10.1371/journal.pone.0242925. eCollection 2020.
No consensus has yet been reached regarding the best anesthetic technique for inguinal hernia repair. This study aimed to compare postoperative clinical outcomes and inflammatory markers among patients who were anesthetized using local, spinal, or general anesthesia for inguinal hernia repair.
This randomized controlled trial included patients scheduled to undergo elective unilateral inguinal hernioplasty at Siriraj Hospital during November 2014 to September 2015 study period. Patients were randomly assigned to the local (LA), spinal (SA), or general (GA) anesthesia groups. Primary outcomes were postoperative pain at rest and on mobilization at 8 and 24 hours after surgery.
Fifty-four patients were included, with 18 patients randomly assigned to each group. Patient demographic and clinical characteristics were similar among groups. There were no significant differences among groups for postoperative pain at rest or on mobilization at 8 and 24 hours after surgery. No significant differences were observed for interleukin-1β, interleukin-6, and interleukin-10 at any time points in any groups. Patients with local anesthesia was associated with less time spent in anesthesia (p = 0.010) and surgery (p = 0.009), lower intraoperative cost (p = 0.003) and total cost in hospital (p = 0.036); however, patient satisfaction in the local anesthesia group (94/100) was statistically significantly lower than the spinal and general anesthesia groups (100/100) (p = 0.010).
No statistically significant difference was observed among groups for postoperative pain scores, duration of hospital stays, complications, or change in inflammatory markers. However, time spent in anesthesia and surgery, the intraoperative cost and total cost for hernia repair, and patient satisfaction were significantly lower in the local anesthesia group than in the other two groups.
对于腹股沟疝修补术，哪种麻醉技术最佳尚未达成共识。本研究旨在比较局部麻醉、脊髓麻醉和全身麻醉用于腹股沟疝修补术的术后临床结果和炎症标志物。
这是一项在 2014 年 11 月至 2015 年 9 月期间在 Siriraj 医院择期行单侧腹股沟疝修补术的患者中进行的随机对照试验。患者被随机分配到局部麻醉（LA）、脊髓麻醉（SA）或全身麻醉（GA）组。主要结局是术后 8 小时和 24 小时静息和活动时的术后疼痛。
共纳入 54 例患者，每组 18 例患者。各组患者的人口统计学和临床特征相似。术后 8 小时和 24 小时静息和活动时的术后疼痛在各组之间无显著差异。在任何时间点，各组的白细胞介素-1β、白细胞介素-6 和白细胞介素-10 均无显著差异。局部麻醉组的麻醉（p = 0.010）和手术时间（p = 0.009）、术中成本（p = 0.003）和总住院费用（p = 0.036）均较低；然而，局部麻醉组患者的满意度（94/100）显著低于脊髓麻醉组和全身麻醉组（100/100）（p = 0.010）。
各组术后疼痛评分、住院时间、并发症或炎症标志物变化无统计学差异。然而，局部麻醉组的麻醉和手术时间、术中成本和疝修补术总费用以及患者满意度均显著低于其他两组。
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