The Effect of Combined Spinal Epidural Anesthesia on Shoulder Pain in Laparoscopic Extraperitoneal Hernia Surgery.

Deniz Guzey, Turgut Donmez, Mehmet Karabulut, Ahmet Surek, Nalan Saygi Emir, Can Ertug Cayirci, Hande Kandemir, Engin Hatipoglu
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Abstract

Background: Shoulder pain is a condition that seriously discomforts patients and develops caused by a peritoneal tear in laparoscopic extraperitoneal hernia repair (TEP) surgeries. Although surgeons generally prefer general anesthesia for the TEP technique, many studies have been carried out on the use of regional anesthesia in recent years. In our study, we aimed to investigate the efficacy and safety of the combined spinal/epidural anesthesia (CSEA) method to prevent shoulder pain in the TEP technique.

Methods: The patients who operated with the TEP procedure were divided into 2 groups; SA (group 1) and CSEA (group 2). The 2 patient groups were compared in terms of sex, age, body mass index, duration of surgery, total operation time, patient satisfaction, pain scores, length of hospital stay, adverse effects, intraoperative, and postoperative complications.

Results: The number of patients in group 1 was 42 and group 2 was 40. The mean operation time was recorded as 55.9 and 80.2 minutes in groups 1 and 2, respectively, which was statistically significantly shorter in group 1 ( P <0.001). Postoperative pain was significantly less in group 2 for the 4th hour ( P <0.0001) and the 12th hour ( P =0.047). There was no difference between the 2 groups in terms of peritoneal tear ( P =0.860). Intraoperative and postoperative shoulder pain was significantly less in group 2 ( P =0.038, P =0015, respectively).

Conclusion: CSEA is an effective and safe anesthesia method for preventing shoulder pain that develops after TEP surgeries.

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腹腔镜腹膜外疝气手术中脊髓硬膜外联合麻醉对肩痛的影响
背景:肩部疼痛是腹腔镜腹膜外疝修补术(TEP)手术中腹膜撕裂导致患者严重不适的一种症状。虽然外科医生通常倾向于在 TEP 技术中使用全身麻醉,但近年来也有许多关于使用区域麻醉的研究。在我们的研究中,我们旨在探讨脊髓/硬膜外联合麻醉(CSEA)方法在 TEP 技术中预防肩痛的有效性和安全性:将接受 TEP 手术的患者分为两组:SA 组(第 1 组)和 CSEA 组(第 2 组)。比较两组患者的性别、年龄、体重指数、手术时间、手术总时间、患者满意度、疼痛评分、住院时间、不良反应、术中和术后并发症:第一组患者人数为 42 人,第二组患者人数为 40 人。第 1 组和第 2 组的平均手术时间分别为 55.9 分钟和 80.2 分钟,第 1 组的手术时间明显短于第 2 组:CSEA 是一种有效且安全的麻醉方法,可有效预防 TEP 手术后出现的肩部疼痛。
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来源期刊
CiteScore
2.00
自引率
10.00%
发文量
103
审稿时长
3-8 weeks
期刊介绍: Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.
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