A Comparison of Epidural Versus General Anesthesia for Outpatient Endoscopic Preperitoneal Herniorrhaphy |
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Authors: | Alan L Schuricht Cindy S McCarthy Wendi L Wells Ronald J Kumor and Jason Cwik |
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Institution: | 1Department of Surgery, Pennsylvania Hospital, Philadelphia, PA.;2Department of Anesthesia, Pennsylvania Hospital, Philadelphia, PA. |
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Abstract: | Objectives:To study the efficacy of epidural versus general anesthesia on length of stay, patient recovery and anesthetic-related complications in patients undergoing endoscopic preperitoneal herniorrhaphy.Methods:One hundred sixty-seven consecutive patients undergoing endoscopic preperitoneal herniorrhaphy from July, 1994, to August, 1995, were retrospectively studied. A total of 243 herniorrhaphies were performed. Four patients required conversion of epidural anesthesia to general anesthesia because of inadequate sensory blockade (67/71; 94% success rate). One-hundred-forty-eight patients were available for review. Sixty-seven patients underwent successful epidural anesthesia during the case, while 81 patients were managed with general anesthesia.Results:Thirty patients (37%) receiving general anesthesia required interventions for nausea compared to only six patients (9.0%) in the epidural anesthesia group (p<0.001). Thirty patients (37%) in the general anesthesia group required intervention because of complaints of pain, compared to 13 (19.4%) in the epidural group (p<0.05). There were no differences between the two groups for length of stay in OR, PACU, or total hospital times.Conclusions:The use of epidural anesthesia during the performance of endoscopic preperitoneal herniorrhaphy was associated with a decrease in the incidence of postoperative pain and nausea. The technique was successful in 94% of the cases in which it was used. Epidural anesthesia is recommended as an effective alternative to general anesthesia for the performance of outpatient endoscopic preperitoneal herniorrhaphy. |
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Keywords: | Laparoscopic herniorrhaphy Epidural anesthesia |
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