C Sarakatsianou1, S Georgopoulou2, G Tzovaras3, K Perivoliotis3, M-E Papadonta2, I Baloyiannis3. 1. Department of Anesthesiology, University Hospital of Larissa, Biopolis Campus, 41110, Larissa, Greece. heidisarak@gmail.com. 2. Department of Anesthesiology, University Hospital of Larissa, Biopolis Campus, 41110, Larissa, Greece. 3. Department of Surgery, University Hospital of Larissa, 41110, Larissa, Greece.
Abstract
PURPOSE: General anesthesia has been used as a standard type of anesthesia for laparoscopic inguinal hernia repair by the transabdominal preperitoneal (TAPP) approach, regional anesthesia being occasionally used in high-risk patients. We had previously designed a controlled randomized trial, comparing spinal with general anesthesia in non-high-risk patients undergoing TAPP inguinal hernia repair. Our results suggested that spinal anesthesia offers some advantages in postoperative pain and additional opioid consumption during the early postoperative period. In the context of this trial, hemodynamic effects of each type of anesthesia are presented. METHODS:Seventy patients, undergoing elective TAPP inguinal hernia repair were randomized to either general or spinal anesthesia. Data regarding patients' hemodynamic status during the procedure under general or spinal anesthesia were collected, measuring systolic blood pressure (SBP), diastolic blood pressure (SBP), mean arterial pressure (MAP) and heart rate (HR). RESULTS: There was no significant effect of anesthesia type on systolic, diastolic and mean arterial pressure values after induction of anesthesia and induction of pneumoperitoneum, respectively. There was a significant effect on heart rate values after induction of anesthesia and induction of pneumoperitoneum, respectively. CONCLUSIONS:Spinal anesthesia is as effective as general anesthesia concerning hemodynamic stability and seems to provide a better result in maintaining hemodynamic stability with fewer fluctuations in blood pressure and mild alterations in heart rate values during TAPP inguinal hernia repair.
RCT Entities:
PURPOSE: General anesthesia has been used as a standard type of anesthesia for laparoscopic inguinal hernia repair by the transabdominal preperitoneal (TAPP) approach, regional anesthesia being occasionally used in high-risk patients. We had previously designed a controlled randomized trial, comparing spinal with general anesthesia in non-high-risk patients undergoing TAPP inguinal hernia repair. Our results suggested that spinal anesthesia offers some advantages in postoperative pain and additional opioid consumption during the early postoperative period. In the context of this trial, hemodynamic effects of each type of anesthesia are presented. METHODS: Seventy patients, undergoing elective TAPP inguinal hernia repair were randomized to either general or spinal anesthesia. Data regarding patients' hemodynamic status during the procedure under general or spinal anesthesia were collected, measuring systolic blood pressure (SBP), diastolic blood pressure (SBP), mean arterial pressure (MAP) and heart rate (HR). RESULTS: There was no significant effect of anesthesia type on systolic, diastolic and mean arterial pressure values after induction of anesthesia and induction of pneumoperitoneum, respectively. There was a significant effect on heart rate values after induction of anesthesia and induction of pneumoperitoneum, respectively. CONCLUSIONS: Spinal anesthesia is as effective as general anesthesia concerning hemodynamic stability and seems to provide a better result in maintaining hemodynamic stability with fewer fluctuations in blood pressure and mild alterations in heart rate values during TAPP inguinal hernia repair.
Authors: Chamaidi Sarakatsianou; Stavroula Georgopoulou; Ioannis Baloyiannis; Maria Chatzimichail; George Vretzakis; Dimitris Zacharoulis; George Tzovaras Journal: Am J Surg Date: 2017-02-02 Impact factor: 2.565
Authors: A A J van Zundert; G Stultiens; J J Jakimowicz; B E E M van den Borne; W G J M van der Ham; J A W Wildsmith Journal: Br J Anaesth Date: 2006-04 Impact factor: 9.166