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全身麻醉与脊髓麻醉下腹股沟疝完全腹膜外腹腔镜手术结果的评估与比较

Evaluation and Comparison on the Results of Totally Extraperitoneal Laparoscopic Surgery under General and Spinal Anesthesia for Inguinal Hernia.

作者信息

Sayadishahraki Masoud, Safaee Masumeh, Alinezhad Zarir

机构信息

Department of General Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Adv Biomed Res. 2022 Dec 26;11:123. doi: 10.4103/abr.abr_11_21. eCollection 2022.

Abstract

BACKGROUND

Totally extraperitoneal (TEP) hernia repair surgery is one of the recently considered hernioplasty methods. Here, in the current study, we aimed to compare the results of TEP hernia repair surgery in the two groups of general anesthesia and spinal anesthesia.

MATERIALS AND METHODS

This is a randomized clinical trial that was performed in 2018-2019 in Isfahan on 106 patients undergoing TEP inguinal hernia repair. Patients were randomly divided into two groups. The first group underwent TEP inguinal hernia repair surgery under general anesthesia and the second group of patients underwent TEP inguinal hernia repair surgery under spinal anesthesia. Data regarding surgery duration, intensive care unit admission, pain of patients, mean of analgesic injections after the surgery, and complications such as urine retention, seroma, and hematoma, and wound infection were collected. Data were compared between two groups.

RESULTS

We found significantly higher duration of surgery in the spinal anesthesia group ( = 0.02). Patients in the spinal anesthesia group had shorter duration of nutrition regime beginning ( = 0.002) and lower frequencies of urine retention ( = 0.001). Further analysis showed that the mean pain severity was significantly lower in spinal anesthesia group compared to general anesthesia during postoperation measurements ( = 0.001) and patients in spinal anesthesia group received less postoperation analgesics compared to the other group ( = 0.001).

CONCLUSION

TEP surgery under spinal anesthesia was associated with better clinical results such as lower postoperative pain and analgesics injections compared to general anesthesia.

摘要

背景

完全腹膜外(TEP)疝修补手术是近年来被考虑的疝修补方法之一。在本研究中,我们旨在比较全身麻醉和脊髓麻醉两组患者接受TEP疝修补手术的结果。

材料与方法

这是一项随机临床试验,于2018 - 2019年在伊斯法罕对106例行TEP腹股沟疝修补术的患者进行。患者被随机分为两组。第一组在全身麻醉下接受TEP腹股沟疝修补手术,第二组患者在脊髓麻醉下接受TEP腹股沟疝修补手术。收集有关手术时间、重症监护病房入住情况、患者疼痛、术后镇痛注射次数以及尿潴留、血清肿、血肿和伤口感染等并发症的数据。对两组数据进行比较。

结果

我们发现脊髓麻醉组的手术时间明显更长(P = 0.02)。脊髓麻醉组患者开始营养支持的时间更短(P = 0.002),尿潴留发生率更低(P = 0.001)。进一步分析表明,与全身麻醉相比,脊髓麻醉组术后测量时的平均疼痛严重程度明显更低(P = 0.001),且脊髓麻醉组患者术后接受的镇痛药物比另一组更少(P = 0.001)。

结论

与全身麻醉相比,脊髓麻醉下的TEP手术具有更好的临床效果,如术后疼痛和镇痛药物注射次数更少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a90a/9926035/85bc8109e085/ABR-11-123-g001.jpg

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