Hemodynamic effects of anesthesia type in patients undergoing laparoscopic transabdominal preperitoneal inguinal hernia repair under spinal vs general anesthesia
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.
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).
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.
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.
KeywordsGeneral anesthesia Spinal anesthesia Laparoscopic inguinal hernia repair Transabdominal preperitoneal (TAPP) repair Hemodynamic changes
Compliance with ethical standards
Conflict of interest
CS declares no conflict of interest, SG declares no conflict of interest, GT declares no conflict of interest, KP declares no conflict of interest, MEP declares no conflict of interest, IB declares no conflict of interest.
The study was approved by the Institution Ethics Committee with the registration number of UTH5535/12/11.
Human and animals rights
The research was conducted according to the principles of the World Medical Association Declaration of Helsinki “Ethical principles for Medical Research Involving Human Subjects”.
Patients were informed in detail and informed consent was obtained.
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