Comparison of Spinal vs General Anesthesia via Laryngeal Mask Airway in Inguinal Hernia Repair

• Published in: Archives of surgery (Chicago. 1960) Vol. 139; no. 2; pp. 183 - 187
• Main Authors: Burney, Richard E, Prabhu, Mythili A, Greenfield, Mary Lou V. H, Shanks, Amy, O'Reilly, Michael
• Format: Journal Article
• Language: English
• Published: Chicago, IL American Medical Association 01.02.2004
• Subjects: Adult; Aged; Analysis of Variance; Anesthesia, General - adverse effects; Anesthesia, General - methods; Anesthesia, Spinal - adverse effects; Anesthesia, Spinal - methods; Anesthetics, Intravenous - administration & dosage; Biological and medical sciences; Female; Follow-Up Studies; General aspects; Hernia, Inguinal - surgery; Humans; Laryngeal Masks; Lidocaine - therapeutic use; Male; Medical sciences; Middle Aged; Pain Measurement; Probability; Risk Assessment; Sensitivity and Specificity; Time Factors; Treatment Outcome; Medicine; Respiratory tract; Treatment; Surgery; Mask; General anesthesia; Larynx; Repair; Inguinal hernia; Comparative study
• ISSN: 0004-0010; 2168-6254; 1538-3644; 2168-6262
• DOI: 10.1001/archsurg.139.2.183

HYPOTHESIS The use of laryngeal mask airway and propofol in inguinal hernia repair results in shorter operative and recovery room times. DESIGN Randomized control trial. SETTING University hospital. PATIENTS From May 2000 to March 2002, a convenience sample of 79 patients was invited to participate; 34 entered the study. Fifteen patients were randomized to subarachnoid block, and 18 patients were randomized to laryngeal mask airway. No patients withdrew from the study because of adverse effects. All study subjects were followed up for 6 months. INTERVENTION General anesthesia via laryngeal mask airway or lidocaine subarachnoid block anesthesia for inguinal hernia repair. MAIN OUTCOME MEASURES Operative and recovery room times; surgeon evaluation of the adequacy of the anesthetic technique; 36-Item Short-Form Health Survey scores before and after operation. RESULTS Total time from entry into the operating room to discharge home was slightly longer in the subarachnoid block group (285 vs 262 minutes; 95% confidence interval, 251-317 minutes) but this difference was not statistically or clinically significant. Patient satisfaction was high with both techniques; patient-reported outcomes were the same. Surgeons rated muscle relaxation and exposure better with the subarachnoid block. CONCLUSIONS We found no differences between short-acting spinal anesthesia and general anesthesia via laryngeal mask airway with intravenous propofol in efficiency or in early or late outcomes after elective inguinal hernia repair. Surgeon and patient preferences appear to be the most important reasons for selecting an anesthetic technique for individual patients undergoing inguinal hernia repair.Arch Surg. 2004;139:183-187-->