Local anaesthesia versus spinal anaesthesia in inguinal hernia repair: A systematic review and meta-analysis

The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Deepali PrakashRose Galvin

Abstract

Inguinal hernias are a significant cause of morbidity. The purpose of this systematic review and meta-analysis is to determine the totality of evidence regarding the effectiveness of local anaesthesia when compared to spinal anaesthesia in individuals undergoing open inguinal hernia repair. A systematic literature search was conducted. Inclusion criteria were randomised controlled trials (RCTs) comparing spinal and local anaesthesia on clinical and self-reported outcomes, in patients undergoing open inguinal hernia repairs. The methodological quality was assessed using the Cochrane risk of bias tool. The mode of analysis used was the difference in outcomes between the groups post-surgery and at follow-up time points. Statistical heterogeneity was assessed using the I(2) statistic. Ten original RCTs were included, with a total of 1379 patients. There was no significant difference in operative time between the groups [Random Effects Model, MD -0.70 min (95% CI, -5.80 to 4.40 min), p = 0.79, I(2) = 84%]. Patients in the local anaesthetic group experienced significantly less pain than those in the spinal group [Fixed Effects Model, SMD -0.63 (95% CI, -0.81 to -0.46), p < 0.01, I(2) = 49%], lower rates of urinary retention [FEM, RR ...Continue Reading

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Citations

Sep 1, 2018·Lower Urinary Tract Symptoms·Yilmaz Unal, Muhammet Fatih Kilinc
Sep 9, 2019·Hernia : the Journal of Hernias and Abdominal Wall Surgery·P M F de SouzaL R Alberti
Oct 4, 2019·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·J H H OlsenJ Rosenberg
Mar 13, 2020·Hernia : the Journal of Hernias and Abdominal Wall Surgery·Mustafa Kaçmaz, Hacı Bolat
Jul 6, 2017·Hernia : the Journal of Hernias and Abdominal Wall Surgery·S BourgouinP Balandraud
Jun 17, 2020·The Journal of Surgical Research·Lindsey LossSergio Huerta
May 21, 2021·International Journal of Surgery Protocols·UNKNOWN Irish Surgical Research CollaborativeDes C Winter
Nov 27, 2021·Hernia : the Journal of Hernias and Abdominal Wall Surgery·J H H OlsenJ Rosenberg

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