Teasdale C, McCrum A M, Williams N B, Horton R E
Ann R Coll Surg Engl. 1982 Jul;64(4):238-42.
A series of 117 consecutive unselected patients with clinically reducible unilateral inguinal herniae were admitted for short-stay repair. Seven expressed a strong preference for one form of anaesthesia (6 general (GA)) local (LA) and 7 were unfit for GA; these were excluded from the trial. The remaining 103 patients were allocated at random to receive either LA or GA in order to compare the two methods of anaesthesia. The resulting groups (53 LA, 50 GA) were well matched for age and obesity. Perand postoperative symptoms were assessed with linear analogues self-assessment questionnaires. Statistically significant differences were demonstrated between the groups; those patients having LA were able to walk, eat, and pass urine earlier than those having GA, who experienced more nausea, vomiting, sore throat, and headache. The postoperative course and additional symptoms were otherwise similar. Forty-five LA patients experienced mild pain during the operation, but nevertheless 85% of the total group said they would consent to its use again. Ninety-three patients (90%) were discharged at 24 h. LA was applicable to all types of clinically reducible inguinal hernia and was an acceptable, safe, and satisfactory alternative to GA.
117例连续入选的临床可复性单侧腹股沟疝患者接受短期修补手术。7例患者强烈倾向于某种麻醉方式(6例倾向全身麻醉(GA),1例倾向局部麻醉(LA)),7例因不适合全身麻醉被排除在试验之外。其余103例患者随机分配接受局部麻醉或全身麻醉,以比较两种麻醉方法。最终分组(53例局部麻醉,50例全身麻醉)在年龄和肥胖程度方面匹配良好。术前和术后症状通过线性模拟自评问卷进行评估。两组之间存在统计学显著差异;接受局部麻醉的患者比接受全身麻醉的患者更早能够行走、进食和排尿,而全身麻醉的患者出现更多恶心、呕吐、喉咙痛和头痛症状。术后病程和其他症状方面则相似。45例接受局部麻醉的患者在手术期间经历轻度疼痛,但尽管如此,该组中85%的患者表示愿意再次接受局部麻醉。93例患者(90%)在24小时内出院。局部麻醉适用于所有类型的临床可复性腹股沟疝,是全身麻醉可接受、安全且令人满意的替代方法。