Should we abandon regional anesthesia in open inguinal hernia repair in adultsReportar como inadecuado




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European Journal of Medical Research

, 20:76

First Online: 17 September 2015Received: 03 June 2015Accepted: 04 September 2015DOI: 10.1186-s40001-015-0170-0

Cite this article as: Bakota, B., Kopljar, M., Baranovic, S. et al. Eur J Med Res 2015 20: 76. doi:10.1186-s40001-015-0170-0

Abstract

Inguinal hernia repair is a common worldwide surgical procedure usually done in the outpatient setting. The purpose of this systematic review is to make an evidence-based meta-analysis to determine the possible benefits of regional neuraxial block anesthesia compared to general anesthesia in open inguinal hernia repair in adults. Cochrane Library, Medline, EMBASE, CINAHL, SCI-EXPANDED, SCOPUS as well as trial registries, conference proceedings and reference lists were searched. Only randomized controlled trials RCT that compare neuraxial block spinal or-and epidural anesthesia NABA and general anesthesia GA were included. Main outcome measures were postoperative complications, urinary retention and postoperative pain. Seven RCTs were included in this review. A total of 308 patients were analyzed with 154 patients in each group. Overall complications were evenly distributed in NABA and in GA group OR 1.17, 95 % CI 0.52–2.66. Urinary retention was statistically less frequent in GA group compared to NABA group OR 0.25, 95 % CI 0.08–0.74. Movement-associated pain score 24 h after surgery was significantly lower in NABA group SMD 5.59, 95 % CI 3.69–7.50. Time of first analgesia application was shorter in GA group SMD 8.99, 95 % CI 6.10–11.89. Compared to GA, NABA appears to be a more adequate technique in terms of postoperative pain control. However, when GA is applied, patients seem to have less voiding problems.

KeywordsHernia Meta-analysis Systematic review Regional anesthesia General anesthesia Complications AbbreviationsRCTrandomized controlled trials

NABAneuraxial block anesthesia

GAgeneral anesthesia

LAlocal anesthesia

RAregional anesthesia

ORMantel–Haenszel odds ratio

SMDstandardized mean difference

REDerSimonian–Laird random-effect model

NNTnumber needed to treat

VASvisual analogue scale

COPDchronic obstructive pulmonary disease

ASAAmerican Society of Anesthesiologists

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Autor: B. Bakota - M. Kopljar - S. Baranovic - M. Miletic - M. Marinovic - D. Vidovic

Fuente: https://link.springer.com/







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