Laparoscopic Total Extraperitoneal Inguinal Hernia Repair Under Epidural Anesthesia Versus General Anesthesia

Abstract

Introduction: Laparoscopic total extraperitoneal (TEP) inguinal hernia repair is a well-known approach to inguinal hernia repair. The present study aims to compare the advantages and disadvantages of the TEP technique under general anesthesia (GA) and epidural anesthesia (EA). Materials and Methods: The patients were divided into 2 groups as those undergoing TEP under EA (Group 1) and those undergoing TEP under GA (Group 2). The 2 patient groups were compared in terms of sex, age, body mass index data, duration of surgery, total operation time, patient satisfaction, VAS scores (1, 4, 12, and 24 h), length of hospital stay, and postoperative complications. Results: The number of patients operated under EA (Group 1) was 30, and the number of patients operated under GA (Group 2) was 32. Only in the postoperative first hour VAS scores was statistically significantly less and the need for analgesia evaluated in both groups was found to be statistically significantly lower in Group 1 (P<0.001). The mean operation time was recorded as 62 and 46.50 minutes in Groups 1 and 2, respectively, which was statistically significantly shorter in Group 2 (P<0.001). There was no difference between the 2 groups regarding complications, hospital stay, recovery, or surgery time. Conversion rate is 0 in both groups. Conclusions: Lower postoperative VAS scores and lower postoperative VAS scores and lower analgesic used requirements of EA, it is thought that EA can be safely applied in the TEP procedure as an alternative in patients who cannot be administered GA.

Comparison of General, Epidural, and Spinal Anesthesia in Laparoscopic TEP (Total Extraperitoneal Repair) for Inguinal Hernia

“…8,23 In these 2 meta-analyses, surgery time was found to be longer for SA compared with the GA. In the clinical study of Sürek et al, 24 there was no difference between the EA and GA groups in terms of surgery time, while the total operative time was significantly longer in EA than in GA. In our study, operation times were compared and EA was found to be the longest (group GA: 55.2 ± 12.27 min, group SA: 55.1 ± 8.6 min, and group EA: 63.1 ± 10.18 min) (P < 0.001).…”

“…[33][34][35] There was no difference between SA and GA in terms of seroma and scrotal edema development in 2 meta-analysis studies. 7,8 Sürek et al 24 reported that there was no significant difference between the EA and GA groups in terms of seroma and scrotal edema development. In our study, similar to these studies and meta-analyses, no statistically significant difference was found between the GA, EA, and SA groups in terms of seroma and scrotal edema (P = 0.803 and 0.557).…”

“…The positive effect of regional anesthesia on quality of life was similar to in recent studies. 21,24 EA and SA were compared for the first time in the literature by this paper. The EA group was the most satisfied.…”

“…For this reason, the fact that patients do not feel pain after surgery, in their daily life and during exercise increases their quality of life. 24 Long-term quality of life is particularly relevant to pain and complications. 37 In our study, patients who were operated with GA were the most dissatisfied group, while the SA and EA groups were significantly more satisfied.…”

Risk Factors for Conversion in Laparoscopic Totally Extraperitoneal Inguinal Hernioplasty

“…Patients were treated in a supine Trendelenburg’s position under general anesthesia or regional anesthesia. Epidural anesthesia and spinal anesthesia techniques were used for regional anesthesia 12,13…”