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Open Access 01-12-2015 | Review

Should we abandon regional anesthesia in open inguinal hernia repair in adults?

Authors: B. Bakota, M. Kopljar, S. Baranovic, M. Miletic, M. Marinovic, D. Vidovic

Published in: European Journal of Medical Research | Issue 1/2015

Abstract

Inguinal hernia repair is a common worldwide surgical procedure usually done in the outpatient setting. The purpose of this systematic review is to make an evidence-based meta-analysis to determine the possible benefits of regional (neuraxial block) anesthesia compared to general anesthesia in open inguinal hernia repair in adults. Cochrane Library, Medline, EMBASE, CINAHL, SCI-EXPANDED, SCOPUS as well as trial registries, conference proceedings and reference lists were searched. Only randomized controlled trials (RCT) that compare neuraxial block (spinal or/and epidural) anesthesia (NABA) and general anesthesia (GA) were included. Main outcome measures were postoperative complications, urinary retention and postoperative pain. Seven RCTs were included in this review. A total of 308 patients were analyzed with 154 patients in each group. Overall complications were evenly distributed in NABA and in GA group [OR 1.17, 95 % CI (0.52–2.66)]. Urinary retention was statistically less frequent in GA group compared to NABA group [OR 0.25, 95 % CI (0.08–0.74)]. Movement-associated pain score 24 h after surgery was significantly lower in NABA group [SMD 5.59, 95 % CI (3.69–7.50)]. Time of first analgesia application was shorter in GA group [SMD 8.99, 95 % CI 6.10–11.89]. Compared to GA, NABA appears to be a more adequate technique in terms of postoperative pain control. However, when GA is applied, patients seem to have less voiding problems.

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Title: Should we abandon regional anesthesia in open inguinal hernia repair in adults?
Authors: B. Bakota
M. Kopljar
S. Baranovic
M. Miletic
M. Marinovic
D. Vidovic
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: European Journal of Medical Research / Issue 1/2015
Electronic ISSN: 2047-783X
DOI: https://doi.org/10.1186/s40001-015-0170-0

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