Comparison of spinal vs general anesthesia via laryngeal mask airway in inguinal hernia repair.

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Arch Surg. 2004 Feb;139(2):183-7.  

Comparison of spinal vs general anesthesia via laryngeal mask airway in

inguinal hernia repair.

Burney RE, Prabhu MA, Greenfield ML, Shanks A, O'Reilly M.

Department of Surgery, University of Michigan, Ann Arbor, USA.

rburney@...

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.

PMID: 14769578 [PubMed - in process]