• 重慶市中山醫(yī)院疝疾病治療中心（重慶400013）;

目的 　探討腹股溝疝無張力修補(bǔ)更適宜的麻醉方式。
方法 　將我院2002年3月至2005年3月收治的單側(cè)腹股溝疝病例422例按隨機(jī)數(shù)字表法分為局麻組和硬膜外麻醉組,手術(shù)方法均采用充填式無張力疝修補(bǔ)，設(shè)定觀察指標(biāo)，記錄相關(guān)數(shù)據(jù)（包括手術(shù)時(shí)間、下地時(shí)間、進(jìn)食時(shí)間、住院時(shí)間、恢復(fù)日常生活時(shí)間、傷口并發(fā)癥、術(shù)后麻醉并發(fā)癥、輔助藥物使用率、麻醉滿意率及住院費(fèi)用），填寫問卷調(diào)查表并進(jìn)行隨訪。
結(jié)果 　局麻組和硬膜外麻醉組的輔助藥物使用率、傷口并發(fā)癥發(fā)生率、手術(shù)時(shí)間及恢復(fù)日常生活時(shí)間比較,差異均無統(tǒng)計(jì)學(xué)意義(P＞0.05)；　在對(duì)麻醉滿意率方面兩組均為總體滿意。局麻組下地時(shí)間、進(jìn)食時(shí)間、住院時(shí)間、術(shù)后麻醉并發(fā)癥（惡心/嘔吐、尿潴留）發(fā)生率及住院全部費(fèi)用均明顯低于硬膜外麻醉組，兩組差異有統(tǒng)計(jì)學(xué)意義(P＜0.05）。隨訪期間，兩組患者均無復(fù)發(fā)。
結(jié)論 　大多數(shù)腹股溝疝無張力修補(bǔ)均可在局麻下完成，局部麻醉可成為腹股溝疝無張力修補(bǔ)的常規(guī)麻醉方式。

引用本文： 黃建,劉永強(qiáng),謝偉. 局麻和硬膜外麻醉下腹股溝疝無張力修補(bǔ)手術(shù)的比較分析. 中國(guó)普外基礎(chǔ)與臨床雜志, 2007, 14(3): 312-315. doi: 復(fù)制

1. Callesen T, Bech K, Kehlet H. One-thousand consecutive inguinal hernia repairs under unmonitored local anesthesia [J]. Anesth Analg, 2001; 93(6)∶1373.
2. 馬頌章, 鄭民華. 成人腹股溝疝、 股疝手術(shù)治療方案(修改稿) [J]. 外科理論與實(shí)踐, 2004; 9(1)∶84.
3. Amid PK, Shulman AG, Lichtenstein IL. Local anesthesia for inguinal hernia repair step-by-step procedure [J]. Ann Surg, 1994; 220(6)∶735.
4. 肖乾虎， 陳建川. 716例無張力疝修補(bǔ)術(shù)的回顧性分析 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2004; 11（6）∶526.
5. Gunal O, Arikan Y, Celikel N. Clinical assessment of spinal and epidural anesthesia in inguinal hernia repair [J]. J Anesth, 2002; 16(2)∶119.
6. Kehlet H, Aasvang E. Groin hernia repair: anesthesia [J]. World J Surg, 2005; 29(8)∶1058.
7. Hair A, Duffy K, McLean J, et al. Groin hernia repair in Scotland [J]. Br J Surg, 2000; 87(12)∶1722.
8. Weltz CR, Klein SM, Arbo JE, et al. Paravertebral block anesthesia for inguinal hernia repair [J]. World J Surg, 2003; 27(4)∶425.
9. Song D, Greilich NB, White PF, et al. Recovery profiles and costs of anesthesia for outpatient unilateral inguinal herniorrhaphy [J]. Anesth Analg, 2000; 91(4)∶876.
10. Gonullu NN, Cubukcu A, Alponat A. Comparison of local and general anesthesia in tension-free (Lichtenstein) hernioplasty: a prospective randomized trial [J]. Hernia, 2002; 6(1)∶29.
11. O’Dwyer PJ, Serpell MG, Millar K, et al. Local or general anesthesia for open hernia repair: a randomized trial [J]. Ann Surg, 2003; 237(4)∶574.
12. Kendell J, Wildsmith JA, Gray IG. Costing anaesthetic practice. An economic comparison of regional and general anaesthesia for varicose vein and inguinal hernia surgery [J]. Anaesthesia, 2000; 55(11)∶1106.
13. 馮波， 夏怡， 陸愛國(guó)， 等. 腹腔鏡與開腹直腸前切除術(shù)的衛(wèi)生經(jīng)濟(jì)學(xué)評(píng)價(jià) [J]. 外科理論與實(shí)踐, 2006; 11(5)∶389.
14. Nordin P, Haapaniemi S, van der Linden W, et al. Choice of anesthesia and risk of reoperation for recurrence in groin hernia repair [J]. Ann Surg, 2004; 240(1)∶187.
15. 黃建. 應(yīng)用疝環(huán)充填式無張力修補(bǔ)術(shù)治療腹股溝疝223例臨床經(jīng)驗(yàn) [J]. 重慶醫(yī)學(xué), 2001; 30(5)∶455.
  1. 1. Callesen T, Bech K, Kehlet H. One-thousand consecutive inguinal hernia repairs under unmonitored local anesthesia [J]. Anesth Analg, 2001; 93(6)∶1373.
  2. 2. 馬頌章, 鄭民華. 成人腹股溝疝、 股疝手術(shù)治療方案(修改稿) [J]. 外科理論與實(shí)踐, 2004; 9(1)∶84.
  3. 3. Amid PK, Shulman AG, Lichtenstein IL. Local anesthesia for inguinal hernia repair step-by-step procedure [J]. Ann Surg, 1994; 220(6)∶735.
  4. 4. 肖乾虎， 陳建川. 716例無張力疝修補(bǔ)術(shù)的回顧性分析 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2004; 11（6）∶526.
  5. 5. Gunal O, Arikan Y, Celikel N. Clinical assessment of spinal and epidural anesthesia in inguinal hernia repair [J]. J Anesth, 2002; 16(2)∶119.
  6. 6. Kehlet H, Aasvang E. Groin hernia repair: anesthesia [J]. World J Surg, 2005; 29(8)∶1058.
  7. 7. Hair A, Duffy K, McLean J, et al. Groin hernia repair in Scotland [J]. Br J Surg, 2000; 87(12)∶1722.
  8. 8. Weltz CR, Klein SM, Arbo JE, et al. Paravertebral block anesthesia for inguinal hernia repair [J]. World J Surg, 2003; 27(4)∶425.
  9. 9. Song D, Greilich NB, White PF, et al. Recovery profiles and costs of anesthesia for outpatient unilateral inguinal herniorrhaphy [J]. Anesth Analg, 2000; 91(4)∶876.
  10. 10. Gonullu NN, Cubukcu A, Alponat A. Comparison of local and general anesthesia in tension-free (Lichtenstein) hernioplasty: a prospective randomized trial [J]. Hernia, 2002; 6(1)∶29.
  11. 11. O’Dwyer PJ, Serpell MG, Millar K, et al. Local or general anesthesia for open hernia repair: a randomized trial [J]. Ann Surg, 2003; 237(4)∶574.
  12. 12. Kendell J, Wildsmith JA, Gray IG. Costing anaesthetic practice. An economic comparison of regional and general anaesthesia for varicose vein and inguinal hernia surgery [J]. Anaesthesia, 2000; 55(11)∶1106.
  13. 13. 馮波， 夏怡， 陸愛國(guó)， 等. 腹腔鏡與開腹直腸前切除術(shù)的衛(wèi)生經(jīng)濟(jì)學(xué)評(píng)價(jià) [J]. 外科理論與實(shí)踐, 2006; 11(5)∶389.
  14. 14. Nordin P, Haapaniemi S, van der Linden W, et al. Choice of anesthesia and risk of reoperation for recurrence in groin hernia repair [J]. Ann Surg, 2004; 240(1)∶187.
  15. 15. 黃建. 應(yīng)用疝環(huán)充填式無張力修補(bǔ)術(shù)治療腹股溝疝223例臨床經(jīng)驗(yàn) [J]. 重慶醫(yī)學(xué), 2001; 30(5)∶455.