局麻和硬膜外麻醉下腹股沟疝无张力修补手术的比较分析

目的探讨腹股沟疝无张力修补更适宜的麻醉方式。方法将我院2002年3月至2005年3月收治的单侧腹股沟疝病例422例按随机数字表法分为局麻组和硬膜外麻醉组，手术方法均采用充填式无张力疝修补，设定观察指标，记录相关数据（包括手术时间、下地时间、进食时间、住院时间、恢复日常生活时间、伤口并发症、术后麻醉并发症、辅助药物使用率、麻醉满意率及住院费用），填写问卷调查表并进行随访。结果局麻组和硬膜外麻醉组的辅助药物使用率、伤口并发症发生率、手术时间及恢复日常生活时间比较，差异均无统计学意义（P〉0、05）；在对麻醉满意率方面两组均为总体满意。局麻组下地时间、进食时间、住院时间、术后麻醉并发症（恶心／呕吐、尿潴留）发生率及住院全部费用均明显低于硬膜外麻醉组，两组差异有统计学意义（P〈0．05）。随访期间，两组患者均无复发。结论大多数腹股沟疝无张力修补均可在局麻下完成，局部麻醉可成为腹股沟疝无张力修补的常规麻醉方式。

Comparative Analysis of Local Anaesthesia and Epidural Anaesthesia in Tension-Free Herniorrhaphy

Objective To investigate the most suitable anaesthesia method for the tension-free herniorrhaphy.Methods A total of 422 unilateral inguinal hernia cases from 2002 to 2005 were collected and randomly divided into the local anaesthesia group and epidural anaesthesia group. Observation indices and some relative data, such as operative duration, date of ambulation, date of foodintake, length of hospital stay, operation-correlated complications, anaesthesia complications, usage rate of ancillary drug, satisfactory rate for anesthesia, cost of hospitalization, were included and recorded in the questionnaire, and all the patients who took the tension-free herniorrhaphy were asked to answer it as the follow-up research. Results It was found that the occurrence of postoperative anaesthetic complications, the cost of hospitalization, length of stay of local anaesthesia group were significantly less than those of epidural anaesthesia group, and the date of moving and the date of foodintake were also significantly earlier than those of the other group (P<0.05). However, there was no significant difference of operative duration, postoperative recovery situation and the satisfactory rate between two groups (P>0.05). Conclusion The local anaesthesia is suitable for most of the tension-free herniorrhaphy, and it may be used as the conventional anaesthetic method.