Lin Cheng, Noh Edward, Stamov Philip, Jang SeonHo, Kumar Kamal
Anesthesiology, Western University, London, CAN.
Schulich School of Medicine and Dentistry, Western University, London, CAN.
Cureus. 2022 Sep 3;14(9):e28745. doi: 10.7759/cureus.28745. eCollection 2022 Sep.
Background Associated advantages of ilioinguinal/iliohypogastric block and sedation versus general anesthesia (GA) for inguinal hernia repair have not been reported. The use of regional anesthesia (RA) is advantageous during the COVID-19 pandemic as it eliminates the need for airway manipulation.This study aimed to determine the association between postoperative recovery time when ilioinguinal/iliohypogastric block and sedation were utilized for inguinal hernia versus GA. Method This single-center retrospective study used multivariable logistic regression to model the anesthetic modality as a function of age, sex, body mass index (BMI), American Society of Anesthesiologists (ASA) physical status, major comorbidities to generate a propensity score for each patient for matching. Results After screening 295 patients, 80 patients each in the general and regional anesthesia groups were matched.RA was associated with a 35.6 minutes (95% CI: -46.6 to -25.0) shorter total postoperative recovery time when compared to GA without the increased preoperative time and adverse outcomes. Conclusions Inguinal hernia repair, when performed under ilioinguinal/iliohypogastric block and sedation, was associated with reduced postoperative recovery time. This can be advantageous during the time of the COVID-19 pandemic to reduce the risk of aerosol generation and shorten hospital stay. Future research can focus on establishing a causal relationship.
背景 与全身麻醉（GA）相比，腹股沟疝修补术中采用髂腹股沟/髂腹下神经阻滞联合镇静的相关优势尚未见报道。在2019冠状病毒病大流行期间，使用区域麻醉（RA）具有优势，因为它无需气道操作。本研究旨在确定腹股沟疝修补术中采用髂腹股沟/髂腹下神经阻滞联合镇静与采用GA相比时术后恢复时间之间的关联。方法 本单中心回顾性研究使用多变量逻辑回归将麻醉方式建模为年龄、性别、体重指数（BMI）、美国麻醉医师协会（ASA）身体状况、主要合并症的函数，为每位患者生成倾向得分以进行匹配。结果 在筛选了295例患者后，全身麻醉组和区域麻醉组各有80例患者进行了匹配。与GA相比，RA术后总恢复时间缩短了35.6分钟（95%CI：-46.6至-25.0），且术前时间和不良结局未增加。结论 腹股沟疝修补术在髂腹股沟/髂腹下神经阻滞联合镇静下进行时，术后恢复时间缩短。在2019冠状病毒病大流行期间，这可能有利于降低气溶胶产生风险并缩短住院时间。未来的研究可以专注于建立因果关系。
