局部麻醉和硬膜外麻醉在腹股沟疝无张力修补术中的对照研究

目的 探讨局部麻醉和硬膜外麻醉下行腹股沟疝修补术的疗效与安全性. 方法 2004年1月至2006年12月我院收治的269例腹股沟疝患者,按数字表法随机分为两组,143例采用局部浸润麻醉,126例采用硬膜外麻醉,比较分析两组临床资料. 结果 局部麻醉组在手术(加麻醉)时间、下床时间、住院天数及费用方面均明显少于硬膜外麻醉组(P<0.05),在术中静脉镇静药物使用、术后疼痛程度、恢复日常生活时间上差异无统计学意义(P>0.05).两组患者的伤口及阴囊并发症发生率差异无统计学意义(P>0.05).硬膜外麻醉组术中平均动脉压下降,术后恶心、呕吐、尿潴留发生率显著高于局部麻醉组(P<0.05).两组在随访期内各有1例疝复发(P>0.05). 结论 局部麻醉下行腹股沟疝修补手术简单、安全、经济、可靠,是更为理想的麻醉方式.

Use of local or epidural anesthesia in inguinal hernia repair: a randomized trial

Objective To investigate the efficacy and safety of local anesthesia and epidural anesthesia in tension-free repair of inguinal hernia. Methods Between January 2004 and December 2006, 269 patients underwent inguinal hernia repair were randomly divided into two groups, receiving local anesthesia (143 cases) and epidural anesthesia (126 cases). The clinical data from the two groups were analyzed retrospectively. Results The operation time, ambulation time, length of hospital stay and cost of hospitalization in local anesthesia group were significantly less than those in epidural anesthesia group( P < 0. 05 ). No significant differences were found in intra-operative use of ancillary sedation drugs, postoperative recovery situation, pain scores and operation-correlated complications between the two groups. The occurrence of postoperative anaesthetic complication rate was also significantly lower in local anesthesia group (P < 0. 05 ). One case of recurrence occurred in each group during postoperative follow-up period. Conclusion Tension-free inguinal hernia repair under local anesthesia is a simple, safe, economical, effective procedure and superior to epidural anesthesia.