Background

No consensus has yet been reached regarding the best anesthetic technique for inguinal hernia repair. This study aimed to compare postoperative clinical outcomes and inflammatory markers among patients who were anesthetized using local, spinal, or general anesthesia for inguinal hernia repair.

Methods

This randomized controlled trial included patients scheduled to undergo elective unilateral inguinal hernioplasty at Siriraj Hospital during November 2014 to September 2015 study period. Patients were randomly assigned to the local (LA), spinal (SA), or general (GA) anesthesia groups. Primary outcomes were postoperative pain at rest and on mobilization at 8 and 24 hours after surgery.

Results

Fifty-four patients were included, with 18 patients randomly assigned to each group. Patient demographic and clinical characteristics were similar among groups. There were no significant differences among groups for postoperative pain at rest or on mobilization at 8 and 24 hours after surgery. No significant differences were observed for interleukin-1β, interleukin-6, and interleukin-10 at any time points in any groups. Patients with local anesthesia was associated with less time spent in anesthesia (p = 0.010) and surgery (p = 0.009), lower intraoperative cost (p = 0.003) and total cost in hospital (p = 0.036); however, patient satisfaction in the local anesthesia group (94/100) was statistically significantly lower than the spinal and general anesthesia groups (100/100) (p = 0.010).

Conclusions

No statistically significant difference was observed among groups for postoperative pain scores, duration of hospital stays, complications, or change in inflammatory markers. However, time spent in anesthesia and surgery, the intraoperative cost and total cost for hernia repair, and patient satisfaction were significantly lower in the local anesthesia group than in the other two groups.

中文翻译：

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使用局部，脊柱或全身麻醉修复腹股沟疝后的术后临床结果和炎症标志物：一项随机对照试验

背景

关于腹股沟疝修补的最佳麻醉技术尚未达成共识。这项研究旨在比较使用局麻，脊柱或全身麻醉进行腹股沟疝修补术麻醉的患者的术后临床结局和炎症标志物。

方法

该随机对照试验纳入了计划于2014年11月至2015年9月研究期间在Siriraj医院接受选择性单侧腹股沟疝修补术的患者。患者被随机分为局部（LA），脊柱（SA）或全身（GA）麻醉组。主要结局为术后休息时以及术后8和24小时动员时的术后疼痛。

结果

包括54名患者，每组随机分配18名患者。各组患者的人口统计学和临床​​特征相似。各组之间在休息或手术后8和24小时动员时的术后疼痛无显着差异。在任何组中的任何时间点，均未观察到白介素-1β，白介素-6和白介素10的显着差异。局麻患者的麻醉时间更少（p = 0.010）和手术时间（p = 0.009），术中费用较低（p = 0.003）和住院总费用（p= 0.036）；但是，局部麻醉组（94/100）的患者满意度在统计学上显着低于脊柱和全身麻醉组（100/100）（p = 0.010）。

结论

各组之间在术后疼痛评分，住院时间，并发症或炎症标志物变化方面均未观察到统计学上的显着差异。但是，局部麻醉组的麻醉和手术时间，术中费用和疝气修复的总费用以及患者满意度明显低于其他两组。