Comparison of open and laparoscopic total extraperitoneal inguinal hernia repair under blocked spinal anesthesia and general anesthesia
Hippokratia, cilt.28, sa.4, ss.143-149, 2024 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 28 Sayı: 4
- Basım Tarihi: 2024
- Dergi Adı: Hippokratia
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.143-149
- Anahtar Kelimeler: Inguinal hernia, laparoscopic, spinal, general, anesthesia, block
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Using different anesthesia methods, we aimed to compare the intraoperative and early postoperative effects of laparoscopic and open inguinal hernia repair techniques. Methods: We enrolled 68 patients with inguinal hernia into the study, randomly assigned to total extraperitoneal (TEP) repair and Lichtenstein procedures with a 1:1 ratio. Subsequently, we randomly assigned groups’ participants into two subgroups with a 1:1 ratio: those receiving ilioinguinal (II) and iliohypogastric (IH) nerve block with spinal anesthesia (SA group) and those receiving general anesthesia (GA group). We recorded demographic characteristics, clinical features, and surgical site pain levels at the first, fourth, 12th, and 24th postoperative hours [measured using a visual analog scale (VAS)], and compared data between the four groups. Results: We did not modify any patient’s surgical or anesthetic technique planned. We observed no difference in the operative time between the groups (p =0.81). The percentage of patients who experienced pain during surgery was 41.2 % (n =7) in the TEP-SA group and 17.6 % (n =3) in the Open-SA group (p =0.13). In these cases, operations were safely completed with additional sedoanalgesia. Intraoperative complications, such as hypertension, tachycardia, and bradycardia, occurred in only three patients (17.6 %) in the TEP-SA group (p =0.95). When we analyzed postoperative complications, headaches developed in one patient (5.9 %) in the TEP-SA group and in three patients (17.6 %) in the Open-SA group (p =0.95). The lowest VAS value at postoperative first, fourth, and 12th hours was observed in the TEPSA group (p <0.001). Conclusions: The present study investigated the effects of anesthesia type and the surgical method for inguinal hernia, and the results showed that the TEP procedure performed under SA was the best combination because of its positive effects during surgery and in the early postoperative period. HIPPOKRATIA 2024, 28 (4):143-149.