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首页> 外文期刊>Surgical Endoscopy >Laparoscopic extraperitoneal inguinal hernia repair with spinal anesthesia and nitrous oxide insufflation.
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Laparoscopic extraperitoneal inguinal hernia repair with spinal anesthesia and nitrous oxide insufflation.

机译：腹腔镜腹膜外腹股沟疝修补术伴脊髓麻醉和一氧化二氮吹入。

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BACKGROUND: Laparoscopic repair of inguinal hernia is traditionally performed under general anesthesia mainly because of the adverse effects that carbon dioxide pneumoperitoneum has on awake patients. Since a mandatory use of general anesthesia for all hernia repairs is questionable, the feasibility of laparoscopic extraperitoneal herniorraphy using spinal anesthesia combined with nitrous oxide insufflation was investigated. METHODS: Over a 4-month period, February to May 1998, we performed 35 consecutive total extraperitoneal inguinal hernia procedures (24 unilateral, 11 bilateral) using spinal anesthesia and nitrous oxide extraperitoneal gas. Data on operative findings, self-reported operative and postoperative pain and discomfort (visual analog pain scale), procedure-related hemodynamics, and complications were collected prospectively. RESULTS: All 35 procedures were completed laparoscopically without the need to convert to general anesthesia. Mean operative time was 39 +/- 7 min for unilateral hernia and 65 +/- 10 min for bilateral hernia. Incidental peritoneal tears occurred in 22 patients (63%) resulting in nitrous oxide pneumoperitoneum, which was well tolerated. The patients remained hemodynamically stable throughout the procedure, and operative conditions and visibility were excellent. Complications at a mean of 4 months after the procedure included seven uninfected seromas (20%), three patients with transient testicular pain, and one (3%) recurrence. CONCLUSIONS: Laparoscopic total extraperitoneal hernia repair can be safely and comfortably performed using spinal anesthesia with extraperitoneal nitrous oxide insufflation gas. This method provides a good alternative to general anesthesia.
机译：背景：腹腔镜腹股沟疝的修补术传统上是在全身麻醉下进行，这主要是因为二氧化碳气腹对清醒患者具有不良影响。由于在所有疝气修补术中强制使用全身麻醉存在疑问，因此，研究了使用脊柱麻醉结合一氧化二氮吹入腹腔镜腹膜外疝的可行性。方法：在1998年2月至1998年5月的4个月内，我们使用脊髓麻醉和一氧化二氮腹膜外气体连续进行了35次腹膜外腹股沟疝手术（单侧24例，双侧11例）。前瞻性收集有关手术结果，自我报告的手术和术后疼痛和不适（视觉模拟疼痛量表），与手术相关的血流动力学和并发症的数据。结果：全部35项手术均在腹腔镜下完成，无需转换为全身麻醉。单侧疝的平均手术时间为39 +/- 7分钟，双侧疝的平均手术时间为65 +/- 10分钟。意外腹膜撕裂发生在22例患者（63％）中，导致耐受性良好的一氧化二氮气腹。在整个手术过程中，患者的血流动力学保持稳定，手术条件和可见度均极佳。手术后平均4个月的并发症包括7例未感染的血清瘤（20％），3例短暂性睾丸疼痛患者和1例（3％）复发。结论：腹腔镜全腹膜外疝修补术可以安全，舒适地使用脊柱麻醉和腹膜外一氧化二氮吹入气体进行。该方法为全身麻醉提供了很好的替代方法。

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