Comparison of spinal anesthesia and general anesthesia in inguinal hernia repair in adult: a systematic review and meta-analysis
Abstract Background Inguinal hernia repair is one of the most commonly performed surgical procedures. To date, there is no consensus on which anesthesia should be used. The objective of this meta-analysis was to assess the efficacy of spinal anesthesia (SA) vs. general anesthesia (GA) in inguinal he...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2020-03-01
|
Series: | BMC Anesthesiology |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s12871-020-00980-5 |
id |
doaj-920081f60e6348ff869247427fe408f5 |
---|---|
record_format |
Article |
spelling |
doaj-920081f60e6348ff869247427fe408f52020-11-25T03:59:36ZengBMCBMC Anesthesiology1471-22532020-03-0120111210.1186/s12871-020-00980-5Comparison of spinal anesthesia and general anesthesia in inguinal hernia repair in adult: a systematic review and meta-analysisLin Li0Yi Pang1Yongchao Wang2Qi Li3Xiangchao Meng4Department of Thyroid, Breast, Hernia Surgery, Tianjin the third Central HospitalDepartment of Thyroid, Breast, Hernia Surgery, Tianjin the third Central HospitalDepartment of Thyroid, Breast, Hernia Surgery, Tianjin the third Central HospitalDepartment of Thyroid, Breast, Hernia Surgery, Tianjin the third Central HospitalDepartment of Thyroid, Breast, Hernia Surgery, Tianjin the third Central HospitalAbstract Background Inguinal hernia repair is one of the most commonly performed surgical procedures. To date, there is no consensus on which anesthesia should be used. The objective of this meta-analysis was to assess the efficacy of spinal anesthesia (SA) vs. general anesthesia (GA) in inguinal hernia repair in adults. Methods Eligible studies were identified before January 2020 from PubMed, Embase, ScienceDirect, Cochrane Library, Scopus database as well as reference lists. Outcomes included surgery time, the time in the operation room, the length of hospital stay, pain scores, patient satisfaction, and postoperative complications. Subgroup analysis based on surgical approaches was conducted. Results Six randomized controlled trials (RCT) and five cohort studies were included. A total of 2593 patients were analyzed. Compared to GA, SA was associated with a longer surgery time (weighted mean difference [WMD]: − 3.28, 95%confident interval [CI]: − 5.76, − 0.81), particularly in laparoscopic repair. Postoperative pain at 4 h and 12 h were in favor of SA following either open or laparoscopic repairs (standard mean difference [SMD]: 1.58; 95%CI: 0.55, 2.61, SMD: 0.99, 95%CI: 0.37, 1.60, respectively); and considering borderline significance, patients receiving SA might be more satisfied with the anesthesia they used for herniorrhaphy (SMD: -0.32, 95%CI: − 0.70, 0.06). Some major complications of scrotal edema, seroma, wound infection, recurrence, shoulder pain were comparable between the two groups. However, patients receiving SA had an increased risk of postoperative urinary retention and headache when compared with GA (relative ratio [RR]: 0.44, 95% CI: 0.23, 0.86, RR: 0.33, 95% CI: 0.12, 0.92, respectively). There was a tendency that the incidence of postoperative nausea and vomiting was lower in SA than GA (RR: 2.12, 95%CI: 0.95, 4.73), especially in open herniorrhaphy. Conclusions SA can be another good choice for pain relief no matter in open or laparoscopic hernia repairs, but it can’t be confirmed that SA is better than GA.http://link.springer.com/article/10.1186/s12871-020-00980-5Inguinal hernia repairSpinal anesthesiaGeneral anesthesiaMeta-analysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lin Li Yi Pang Yongchao Wang Qi Li Xiangchao Meng |
spellingShingle |
Lin Li Yi Pang Yongchao Wang Qi Li Xiangchao Meng Comparison of spinal anesthesia and general anesthesia in inguinal hernia repair in adult: a systematic review and meta-analysis BMC Anesthesiology Inguinal hernia repair Spinal anesthesia General anesthesia Meta-analysis |
author_facet |
Lin Li Yi Pang Yongchao Wang Qi Li Xiangchao Meng |
author_sort |
Lin Li |
title |
Comparison of spinal anesthesia and general anesthesia in inguinal hernia repair in adult: a systematic review and meta-analysis |
title_short |
Comparison of spinal anesthesia and general anesthesia in inguinal hernia repair in adult: a systematic review and meta-analysis |
title_full |
Comparison of spinal anesthesia and general anesthesia in inguinal hernia repair in adult: a systematic review and meta-analysis |
title_fullStr |
Comparison of spinal anesthesia and general anesthesia in inguinal hernia repair in adult: a systematic review and meta-analysis |
title_full_unstemmed |
Comparison of spinal anesthesia and general anesthesia in inguinal hernia repair in adult: a systematic review and meta-analysis |
title_sort |
comparison of spinal anesthesia and general anesthesia in inguinal hernia repair in adult: a systematic review and meta-analysis |
publisher |
BMC |
series |
BMC Anesthesiology |
issn |
1471-2253 |
publishDate |
2020-03-01 |
description |
Abstract Background Inguinal hernia repair is one of the most commonly performed surgical procedures. To date, there is no consensus on which anesthesia should be used. The objective of this meta-analysis was to assess the efficacy of spinal anesthesia (SA) vs. general anesthesia (GA) in inguinal hernia repair in adults. Methods Eligible studies were identified before January 2020 from PubMed, Embase, ScienceDirect, Cochrane Library, Scopus database as well as reference lists. Outcomes included surgery time, the time in the operation room, the length of hospital stay, pain scores, patient satisfaction, and postoperative complications. Subgroup analysis based on surgical approaches was conducted. Results Six randomized controlled trials (RCT) and five cohort studies were included. A total of 2593 patients were analyzed. Compared to GA, SA was associated with a longer surgery time (weighted mean difference [WMD]: − 3.28, 95%confident interval [CI]: − 5.76, − 0.81), particularly in laparoscopic repair. Postoperative pain at 4 h and 12 h were in favor of SA following either open or laparoscopic repairs (standard mean difference [SMD]: 1.58; 95%CI: 0.55, 2.61, SMD: 0.99, 95%CI: 0.37, 1.60, respectively); and considering borderline significance, patients receiving SA might be more satisfied with the anesthesia they used for herniorrhaphy (SMD: -0.32, 95%CI: − 0.70, 0.06). Some major complications of scrotal edema, seroma, wound infection, recurrence, shoulder pain were comparable between the two groups. However, patients receiving SA had an increased risk of postoperative urinary retention and headache when compared with GA (relative ratio [RR]: 0.44, 95% CI: 0.23, 0.86, RR: 0.33, 95% CI: 0.12, 0.92, respectively). There was a tendency that the incidence of postoperative nausea and vomiting was lower in SA than GA (RR: 2.12, 95%CI: 0.95, 4.73), especially in open herniorrhaphy. Conclusions SA can be another good choice for pain relief no matter in open or laparoscopic hernia repairs, but it can’t be confirmed that SA is better than GA. |
topic |
Inguinal hernia repair Spinal anesthesia General anesthesia Meta-analysis |
url |
http://link.springer.com/article/10.1186/s12871-020-00980-5 |
work_keys_str_mv |
AT linli comparisonofspinalanesthesiaandgeneralanesthesiaininguinalherniarepairinadultasystematicreviewandmetaanalysis AT yipang comparisonofspinalanesthesiaandgeneralanesthesiaininguinalherniarepairinadultasystematicreviewandmetaanalysis AT yongchaowang comparisonofspinalanesthesiaandgeneralanesthesiaininguinalherniarepairinadultasystematicreviewandmetaanalysis AT qili comparisonofspinalanesthesiaandgeneralanesthesiaininguinalherniarepairinadultasystematicreviewandmetaanalysis AT xiangchaomeng comparisonofspinalanesthesiaandgeneralanesthesiaininguinalherniarepairinadultasystematicreviewandmetaanalysis |
_version_ |
1724453867337285632 |