Springer Online Journal Archives 1860-2000
Summary The treatment of inguinal hernias using laparoscopy can be performed without violating the peritoneal cavity using the totally extraperitoneal technique (TEP). This procedure is usually done with general anaesthesia. The objective of this article is to evaluate the general and regional anaesthesia techniques in extraperitoneal laparoscopic surgery for treating inguinal hernias in an outpatient surgery unit. A prospective clinical study of 131 patients with uncomplicated inguinal hernia undergoing surgery using extraperitoneal laparoscopy was completed. Two study groups were established according to the anaesthesia technique used: general (n = 90) and regional (n = 41). We analyzed clinical data (age, sex, associated diseases, prior abdominal surgery, site and hernia type), intra-operative complications (bleeding, peritoneal rupture, subcutaneous emphysema, reconversion rate, haemodynamic stability, respiratory problems and degree of satisfaction), postoperative complications (haematomas, urinary retention, post lumbar puncture headaches, nausea, vomiting and postoperative pain) and recurrence rate. General anaesthesia was used significantly more in the cases of prior infra-umbilical surgery and bilateral hernias (p 〈 0.05). Statistically significant differences were not shown for intra- or post-operative complications. The rate of conversion was higher for general (5.5%) than for regional anaesthesia (2.4%). Recurrence was detected only in the regional anaesthesia group. In conclusion, general anaesthesia is not required for the performance of extraperitoneal laparoscopic inguinal hernia repair; regional anaesthesia is a safe and efficient alternative.
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