Laparoscopic total extraperitoneal repair under spinal anesthesia versus general anesthesia: a randomized prospective study

Turgut Donmez, Vuslat Muslu Erdem, Oguzhan Sunamak, Duygu Ayfer Erdem, Huseyin Imam Avaroglu, Turgut Donmez, Vuslat Muslu Erdem, Oguzhan Sunamak, Duygu Ayfer Erdem, Huseyin Imam Avaroglu

Abstract

Background: Laparoscopic total extraperitoneal (TEP) inguinal hernia repair is a well-known approach to inguinal hernia repair that is usually performed under general anesthesia (GA). To date, no reports compare the efficacy of spinal anesthesia (SA) with that of GA for laparoscopic hernia repairs. The purpose of this study was to compare the surgical outcome of TEP inguinal hernia repair performed when the patient was treated under SA with that performed under GA.

Materials and methods: Between July 2015 and July 2016, 50 patients were prospectively randomized to either the GA TEP group (Group I) or the SA TEP group (Group II). Propofol, fentanyl, rocuronium, sevoflurane, and tracheal intubation were used for GA. Hyperbaric bupivacaine (15 mg) and fentanyl (10 µg) were used for SA to achieve a sensorial level of T3. Intraoperative events related to SA, operative and anesthesia times, postoperative complications, and pain scores were recorded. Each patient was asked to evaluate the anesthetic technique by using a direct questionnaire filled in 3 months after the operation.

Results: All the procedures were completed by the allocated method of anesthesia as there were no conversions from SA to GA. Pain was significantly less for 1 h (P<0.0001) and 4 h (P=0.002) after the procedure for the SA and GA groups, respectively. There was no difference between the two groups regarding complications, hospital stay, recovery, or surgery time. Generally, patients were more satisfied with SA than GA (P<0.020).

Conclusion: TEP inguinal hernia repair can be safely performed under SA, and SA was associated with less postoperative pain, better recovery, and better patient satisfaction than GA.

Keywords: TEP; general anesthesia; inguinal hernia; spinal anesthesia.

Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
CONSORT flow diagram. Notes: Group I, TEP inguinal hernia repair under general anesthesia; Group II, TEP inguinal hernia repair under spinal anesthesia. Abbreviation: TEP, total extraperitoneal.
Figure 2
Figure 2
Postoperative pain graphics. Abbreviations: TEP, total extraperitoneal; VAS, visual analog scale; h, hours.

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Source: PubMed

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