1 Sevtap HEK, Elif ÇOPUROLU, BELİZ BİLGİLİ, Gönül SAIROLU, Tamer SAIROLU

COMPARISON OF EPIDURAL VERSUS SPINAL ANESTHESIA METHODS FOR INGUINAL HERNIA SURGERIES

Amaç: Randomize ve prospektif çalışmada, inguinal herni operasyonlarında, hasta konforu, kalitesi ve perioperatifkomplikasyonlar açısından spinal ve epidural anestezi yöntemlerinin karşılaştırılması amaçlandı. Yöntem: Elektif inguinal herni onarımı yapılan 75 hasta, spinal anestezi grubu (SA grub, n = 37), epidural anestezi grubu(EA grubu, n = 38) olarak randomize edildi. Her bir gruptaki hastalar intraoperatif hipotansiyon, anestezi başlama zamanı, ameliyatsüresi, intravenöz sıvı tüketimi, postoperatif ağrı, ağrı başlangıç zamanı (FPT), perioperatif komplikasyonlar ve hastanede kalışsüreleri açısından karşılaştırıldı.Bulgular: SA grubunda ortalama anestezi başlama zamanı (5.08 vs 11.47 dakika) EA grubuna göre anlamlı olarak dahadüşüktü (p

İnguinal Herni Operasyonlarında Spinal ve Edidural Anestezi Yöntemlerinin Karşılaştırılması

Objective: This randomized prospective study aimed to compare the quality of two anesthetic techniques, patient comfort, andperioperative complications of spinal versus epidural anesthesia for inguinal hernia repair.Method: Seventy-five consented patients undergoing elective inguinal hernia repair were randomized into: spinal anesthesiagroup (SA group, n=37) and epidural anesthesia group (EA group, n=38). Patients in each group were compared for intraoperativehypotension, time of onset of anesthesia, duration of surgery, intravenous fluid consumption, postoperative pain, first pain sensationtime (FPT), perioperative complications and hospital length of stay. Results: The SA group had significantly shorter mean time of onset for anesthesia (5.08 vs 11.47 min) than the EA group(p

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1. Chung RS, Rowland DY. Meta-analyses of randomized controlled trials of laparoscopic vs conventional inguinal hernia repairs. Surg Endosc 1999; 13: 689-694.
2. Behnia R, Hashemi F, Stryker SJ, Ujiki GT, Poticha SM. A comparison of general versus local anesthesia during inguinal herniorrhaphy. Surg Gynecol Obstet 1992; 174: 277-280.
3. Philbin DM, Bland JH. The cardiovascular effects of anesthetics: an introduction. Int Anesthesiol Clin 1979; 17: 1-11.
4. Albright GA. Cardiac arrest following regional anesthesia with etidocaine or bupivacaine. Anesthesiology 1979; 51: 285-287.
5. Korttila K. Regional anaesthesia for outpatients. Minerva Anestesiol 1999; 65: 401-404.
6. Gupta A, Axelsson K, Thörn SE, et al. Low-dose bupivacaine plus fentanyl for spinal anesthesia during ambulatory inguinal herniorrhaphy: a comparison between 6 mg and 7.5 mg of bupivacaine. Acta Anaesthesiol Scand 2003; 47: 13-19.
7. Barber WB, Smith LE, Zaloga GP, et al. Hemodynamic and plasma catecholamine responses to epinephrine-containing perianal lidocaine anesthesia. Anesth Analg 1985; 64: 924-928.
8. Davis S, Erskine R, James MF. A comparison of spinal and epidural anaesthesia for hip arthroplasty. Can J Anaesth 1992; 39: 551-554.
9. Günal O, Arikan Y, Celikel N. Clinical assessment of spinal and epidural anesthesia in inguinal hernia repair. J Anesth 2002; 16: 119-122.
10. Miller RD,Eriksson EI, Fleisher LA, Wiener-Kronish JP, Young WL. Miller’s Anesthesia 7th edition. Churchill Livingstone: 409, Vol 1. 2009; 1616-1618.
11. Schewe JC, Komusin A, Zinserling J, Nadstawek J, Hoeft A, Hering R. Effects of spinal anaesthesia versus epidural anaesthesia for caesarean section on postoperative analgesic consumption and postoperative pain. Eur J Anaesthesiology 2009; 26: 52-59.
12. Kehlet H, Wilmore DW. Evidence-based surgical care ad the evolution of fast-track surgery. Ann Surg 2008; 248: 189-198.
13. Levy BF, Scott MJ, Fawcett W, Fry C, Rockall TA. Randomized clinical trial of epidural, spinal or patient-controlled analgesia for patients undergoing laparoscopic colorectal surgery. Br J Surg 2011; 98: 1068-1078.
14. Mohammadi-Fallah M, Hamedanchi S, Tayyebi-Azar A. Preventive effect of tamsulosin on postoperative urinary retention. Korean J Urol 2012; 53: 419-423.
15. Lau H, Lam B. Management of postoperative urinary retention: a randomized trial of in-out versus overnight catheterization. ANZ J Surg 2004; 74: 658-661.
16. Pavlin DJ, Pavlin EG, Gunn HC, Taraday JK, Koerschgen ME. Voiding in patients managed with or without ultrasound monitoring of bladder volume after outpatient surgery. Anesth Analg 1999; 89: 90-97.
17. Mulroy MF, Salinas FV, Larkin KL, Polissar NL. Ambulatory surgery patients may be discharged before voiding after short-acting spinal and epidural anesthesia. Anesthesiology 2002; 97: 315-319.