关键词: 腹股沟疝, 局部麻醉, 无张力修补术, 硬外麻醉

Abstract: ［Abstract］ Objetive To investigate the most suitable anaesthesia method for the tension?free herniorrhaphy in the primary hospitals under the limited condition by comparative study of the effect of local anesthesia and epidural anesthesia in tension?free repair of inguinal hernia. Methods A total of 102 unilateral inguinal hernia cases from July 2016 to January 2017 were collected and divided into the local anaesthesia group and epidural anaesthesia group. All patients in two groups were operated with high ligation of hernia sac and flat mesh repair of inguinal hernia. The operation time and postoperative wound pain time, postoperative adverse reactions and complications were compared between the two groups. The postoperative patients′ satisfaction with the anesthetic effect was recorded. After the discharge, the patients were reviewed once a week in the first month. Telephone follow?up was performed once a month for two years. Results There was no significant difference of subcutaneous hematoma, wound infection, scrotal swelling, inguinal nerve and abdominal organ injury and the duration of postoperative pain between two groups（P>0.05）. It was found that hospital stay and the occurrence of complication of Nausea/ vomiting, Headache/dizzy, and uroschesis in local anaesthesia group were significantly lessor lower than those in epidural anaesthesia group（P<0.05）. Two patients had chronic pain in each group during the 2?year follow?up, and were improved by NSAIDs. There were no statistically significant differences in VAS scores between the two groups at 1 month, 6 months, 12 months, and 24 months（Table 3）. The patients in the epidural group were more satisfied anesthesia than those in the local anesthesia group. Conclusion It is feasible to perform tension?free repair of open inguinal hernia under local anesthesia in primary hospitals, and it does not increase the incidence of chronic pain.

Key words: epidural anaesthesia, tension?free herniorrhaphy, local anaesthesia, chronic pain, inguinal hernia