| Objective: The inguinal hernia is a common disease of adults surgical diseases.It is a common view that tension-free hernia repair is the main surgical method for the treatment of inguinal hernia.It has the advantages of quick recovery,with low recurrence rate and less complication.,In order to seek a smaller stress reaction way of anesthesia to patients,to provide reliable clinical basis for the anesthesiologist and surgeon,we compared the local anesthesia and epidural anesthesia in inguinal hernia without stress reaction in patients undergoing tension-free repair.Methods: Withstrict criteria,we selected 60 cases of male primary unilateral inguinal hernia in second hospital of Hebei Medical University from January 2015 to January 2016.According to different methods of anesthesia,the samples were randomly divided into 2 groups with30 cases in each group(n=30).There are 30 cases of ocal anesthesias and 30 casesof continuous epidural anesthesia(continuous the epidural anesthesia group).Two groups of patients were treated with tension-free inguinal hernia repair(Millikan).The hernia repair materials used Italian Herniamesh hernia patch.Comparing two groups of patients before anaesthesia(T0),30 min after anesthesia(T1)and the end of operation(T2),24 h after operation(T3)ACTH each time node(ACTH),epinephrine(E),norepinephrine(NE),blood glucose(Glu)index changes.We use SPSS17.0 software analysis.P<0.05 means that the difference was statistically significant.Results:1 The ACTH changes in both groupsBefore anesthesia(T0)plasma,thelevel of ACTH in local anesthesia group and epidural group,has no significant difference,and no statistical significance(P>0.05).30 min later,theanesthesia(T1)plasma ACTH level of two groups was significantly higher than before anesthesia(T0).The comparison between groups of local anesthesia group was lower than that of the continuous epidural anesthesia group.The difference was statistically significant(P<0.05);The level of postoperative(T2)plasma ACTH group was lower than that of T1 two time point,but the difference was significantly higher than T0 time points.The comparison between groups of local anesthesia group was lower than that of continuous epidural anesthesia group,plasma ACTH levels.The difference was statistically significant(P<0.05);For postoperative 24h(T3),there was no significant difference between the two groups in plasma ACTH level and T0 time points(P>0.05).For thecomparison between groups of local infiltration anesthesia group and epidural anesthesia plasma level of ACTH,there was no significant difference between the two groups(P>0.05).2 E changes in both groupsBefore anesthesia(T0)the plasma levels of E in local anesthesia group and epidural group,no significant difference between the groups,no statistical significance(P>0.05)30min after anesthesia(T1)plasma E levels of two group was significantly higher than that before anesthesia(T0),comparison between groups of local anesthesia group was lower than that of the continuous epidural anesthesia group,the difference was statistically significant(P<0.05);postoperative(T2)plasma level of E group was lower than that of T1 two time point,but significantly higher than T0 time points comparison between groups of local anesthesia group was lower than that of continuous epidural anesthesia group,plasma E levels,the difference was statistically significant(P<0.05);postoperative 24h(T3),There was no significant difference between the two groups in plasma E level and T0 time points(P>0.05),comparison between groups of local infiltration anesthesia group and epidural anesthesia plasma level of E,there was no significant difference between the two groups(P>0.05).3 NE changes in both groupsBefore anesthesia(T0)plasma levels of NE in local anesthesia group and epidural group,no significant difference between the groups,no statistical significance(P>0.05).30 min after anesthesia(T1)plasma NE levels of two group was significantly higher than that before anesthesia(T0),comparison between groups of local anesthesia group was lower than that of the continuous epidural anesthesia group,the difference was statistically significant(P<0.05);postoperative(T2)plasma level of NE group was lower than that of T1 two time point,but significantly higher than T0 time points comparison between groups of local anesthesia group was lower than that of continuous epidural anesthesia group,plasma NE levels,the difference was statistically significant(P<0.05);postoperative 24h(T3),There was no significant difference between the two groups in plasma NE level and T0 time points(P>0.05),comparison between groups of local infiltration anesthesia group and epidural anesthesia plasma level of NE,there was no significant difference between the two groups(P>0.05).4 Glu changes in both groupsBefore anesthesia(T0)plasma levels of Glu in local anesthesia group and epidural group,no significant difference between the groups,no statistical significance(P>0.05).30 min after anesthesia(T1)plasma Glu levels of two group was significantly higher than that before anesthesia(T0),comparison between groups of local anesthesia group was lower than that of the continuous epidural anesthesia group,the difference was statistically significant(P<0.05);postoperative(T2)plasma level of Glu group was lower than that of T1 two time point,but significantly higher than T0 time points comparison between groups of local anesthesia group was lower than that of continuous epidural anesthesia group,plasma Glu levels,the difference was statistically significant(P<0.05);postoperative 24h(T3),There was no significant difference between the two groups in plasma Glu level and T0 time points(P>0.05),comparison between groups of local infiltration anesthesia group and epidural anesthesia plasma level of Glu,there was no significant difference between the two groups(P>0.05).Conclusion: The stress response of tension-free inguinal hernia repair under local anesthesia is less than that of continuous epidural anesthesia.Inguinal hernia tension-free repair with local anesthesia can not only meet the anesthetic effect of surgery,but also can help patients recover after surgery.It can ensure the safety of patients.Therefore,local infiltration anesthesia can be used as the first choice for inguinal hernia tension-free repair. |
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