Local, regional, or general anaesthesia in groin hernia repair:: multicentre randomised trial
Local, regional, or general anaesthesia in groin hernia repair:: multicentre randomised trial
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DOI：
10.1016/s0140-6736(03)14339-5
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发表时间：
2003-09-13
期刊：
影响因子：
168.9
通讯作者：
Nilsson, E
中科院分区：
文献类型：
--
作者：
Nordin, P;Zetterström, H;Nilsson, E
在专业中心，腹股沟疝手术几乎总是使用局部麻醉;而在常规手术实践中，区域或全身麻醉是首选方法。在这个三臂多中心随机试验中，我们的目的是比较三种麻醉方法，并确定在何种程度上，普通外科医生可以重现与局部麻醉在专业herniacents.Methods之间，1999年1月和2001年12月，616例患者在10家医院，被随机分配到无论是局部，区域，或全身麻醉。主要终点为术后早期和晚期并发症。次要终点为手术和麻醉持续时间、术后住院时间和恢复正常活动时间。分析是由意向treat.Findings局部麻醉术中耐受性高。在术后早期，局部麻醉在几乎所有终点方面均上级其他两种类型。在8天和30天的随访中，三组之间没有显著差异。虽然手术的平均持续时间较长，总的麻醉时间，即从麻醉开始，直到病人离开手术室的时间是显着短于它是区域或全身anesthesias.Interpretation局部麻醉有很大的优势，与区域或全身麻醉相比，如入院时间较短，术后疼痛少，排尿困难少。在专门的疝中心局部麻醉所获得的良好结果，在很大程度上可以由普通外科医生在常规手术实践中重现。
Background In specialised centres, local anaesthesia is almost always used in groin hernia surgery; whereas in routine surgical practice, regional or general anaesthesia are the methods of choice. In this three-arm multicentre randomised trial, we aimed to compare the three methods of anaesthesia and to determine the extent to which general surgeons can reproduce the excellent results obtained with local anaesthesia in specialised hernia centres.Methods Between January, 1999, and December, 2001, 616 patients at ten hospitals, were randomly assigned to have either local, regional, or general anaesthesia. Primary endpoints were early and late postoperative complications. Secondary endpoints were duration of surgery and anaesthesia, length of postoperative hospital stay, and time to normal activity. Analysis was by intention to treat.Findings Intraoperative tolerance for local anaesthesia was high. In the early postoperative period, local anaesthesia was superior to the other two types with respect to almost all endpoints. At 8 days' and 30 days' follow-up, there were no significant differences between the three groups. Although the mean duration of surgery was longer, the total anaesthesia time-ie, time from the start of anaesthesia until the patient left the operating room-was significantly shorter than it was for regional or general anaesthesia.Interpretation Local anaesthesia has substantial advantages compared with regional or general anaesthesia, such as shorter duration of admission, less postoperative pain, and fewer micturition difficulties. The favourable results obtained with local anaesthesia in specialised hernia centres can, to a great extent, be reproduced by general surgeons in routine surgical practice.