Comparative Analysis Of Local Anesthesia And Spinal-epidural Anesthesia Under Tension-free Repair For Groin Hernia

Objective:In recent years, our hospital has carried out tension-free repair for groin hernia under local anesthesia, at present there are two ways of inguinal hernia surgery in the hospital at the same time those are local anesthesia and combined spinal-epidural anesthesia respectively. This paper mainly concludes clinical analysis and comparison on the effects of tension-free repair for groin hernia under local anesthesia with combined spinal-epidural anesthesia. Methods:In this paper, the patients with inguinal hernia treated in our hospital from July 2016 to July 2015 were studied, the group standards: patients with single primary inguinal hernia who meet the criteria for the diagnosis of hernia, exclusion criteria: incarcerated hernia, bilateral hernia, and recurrent hernia are not included in the study. Divided into local anesthesia group and combined spinal-epidural anesthesia group.The local anesthesia group: including 126 cases, 120 cases of male, female 6 cases, 79 cases are type Ⅱ and 67 cases are type Ⅲ. The combined spinal-epidural anesthesia group: including 99 cases, 95 cases of male, female 4 cases, 59 cases are type Ⅱ and 40 cases are type Ⅲ. All operations are performed by our medical team, the operation methods were the same in the two groups. Through the comparison of heart rate, blood pressure, operation time, pain score, postoperative bed time, nausea, vomiting, headache, dizziness, urinary retention, length of hospital stay, hospital expenses, and so forth. Results:Cases in the two groups in age and sex, types of hernia, hernia of different side, the difference of using different patches does not have statistical significance(P>0.05), are comparable. When free hernia sac and filling, the heart rate, diastolic blood pressure difference between the two anesthesia groups was statistically significant(P<0.05), and the heart rate, diastolic blood pressure of spinal-epidural anesthesia group is higher than the local anesthesia group. In other moment there are no statistical difference(P>0.05) of the heart rate, diastolic blood pressure between the two anesthesia groups we consider there is no difference between the heart rate, diastolic blood pressure of the two groups in other time. The systolic blood pressure in the filling of the two anesthesia groups were has significant difference(P<0.05), the spinal-epidural anesthesia group is higher than the local anesthesia group. The comparison of systolic blood pressure of two anesthesia groups in other time to get that there is no statistical difference(P>0.05). In addition to the operation, at other moments, both of the two groups have statistically significant differences(P<0.01) with before the operation in heart rate, systolic pressure, diastolic pressure, and other times the heart rate, systolic blood pressure and diastolic blood pressure were lower than before. The two groups in urinary retention, nausea and dizziness have statistical differences(P<0.01), and spinal-epidural anesthesia group composition is higher than local anesthesia group. And vomiting and headache has no statistically significant difference between the two groups(P>0.05). The differences in operative time, length of hospital stay, hospital expenses, pain scores and postoperative bed time were statistically significant(P<0.001), in addition to the pain score, the rest of the indicators of spinal-epidural anesthesia group are all higher than the local anesthesia group’s. Conclusion:1. The central rate of local anesthesia fluctuation was more sensitive than the spinal-epidural anesthesia group. The heart rate has fallen in the spinal-epidural anesthesia group, but not by much.2. The fluctuation of blood pressure in local anesthesia was significantly higher than in the spinal epidural anesthesia group, but it still in the normal range.3. In anesthesia complications, spinal epidural anesthesia group significantly more than local anesthesia group, but they are generally mild. There was little complication in local anesthesia group.4. In terms of pain, the local anesthesia was significantly more than that of the spinal epidural anesthesia group.5. In terms of operation time, length of stay, hospitalization expenses and postoperative bed time, the local anesthesia group was significantly better than that of the spinal epidural anesthesia group.