PDF(Pubmed)
Abstract：
BACKGROUND: Open mesh repair of inguinal hernia is acceptable and can be performed under local anaesthesia (LA). Individuals with high BMI (Body Mass Index) have often been excluded from LA repairs for varying reasons including safety concerns. Open repair of unilateral inguinal hernia (UIH) amongst individuals with different BMI groups was studied. Its safety profile was investigated using LA volume and length of operation (LO) as endpoints. Operative pain and patient satisfaction were also evaluated.
METHODS: A total of 438 adult patients were studied having excluded underweight patients, those requiring any additional intra-operative analgesia, multiple procedures, or records with incomplete data. Operative pain, patient satisfaction, LO and LA volume were retrospectively studied from the existing data from clinical and operative notes.
RESULTS: It was a predominantly male population (93.2% males) with an age range of 17-94 years peaking in the 60-69 years age group. BMI ranged 19-39 kg/m2 with BMI above normal at 62.8%. LO was 13-100 minutes (average 37 mins {SD = 12}) utilising an average LA volume of 45 ml (SD = 11) per patient. Across BMI groups, no significant difference in LO (P = 0.168) or patient satisfaction (P = 0.388) was seen. Although LA volume (P = 0.011) and pain score (P<0.001) demonstrated statistically significant differences, these did not appear to be clinically relevant. Over 90% in each BMI group experienced mild or no pain and with severe pain reported in only one patient in the entire population. Overall, LA volume required per patient was low and dosage was safe in all BMI groups with significant proportion (89%) of patients evaluated for satisfaction rating their experience ≥ 90 out of 100.
CONCLUSIONS: LA repair is safe and well tolerated irrespective of BMI. BMI is not a viable reason for exclusion of obese/overweight individuals from LA repair.
METHODS: A total of 438 adult patients were studied having excluded underweight patients, those requiring any additional intra-operative analgesia, multiple procedures, or records with incomplete data. Operative pain, patient satisfaction, LO and LA volume were retrospectively studied from the existing data from clinical and operative notes.
RESULTS: It was a predominantly male population (93.2% males) with an age range of 17-94 years peaking in the 60-69 years age group. BMI ranged 19-39 kg/m2 with BMI above normal at 62.8%. LO was 13-100 minutes (average 37 mins {SD = 12}) utilising an average LA volume of 45 ml (SD = 11) per patient. Across BMI groups, no significant difference in LO (P = 0.168) or patient satisfaction (P = 0.388) was seen. Although LA volume (P = 0.011) and pain score (P<0.001) demonstrated statistically significant differences, these did not appear to be clinically relevant. Over 90% in each BMI group experienced mild or no pain and with severe pain reported in only one patient in the entire population. Overall, LA volume required per patient was low and dosage was safe in all BMI groups with significant proportion (89%) of patients evaluated for satisfaction rating their experience ≥ 90 out of 100.
CONCLUSIONS: LA repair is safe and well tolerated irrespective of BMI. BMI is not a viable reason for exclusion of obese/overweight individuals from LA repair.
摘要：
背景：腹股沟疝的开放式网片修补术是可以接受的，可以在局部麻醉（LA）下进行。由于各种原因，包括安全问题，BMI（体重指数）高的个人通常被排除在LA维修之外。研究了具有不同BMI组的个体中单侧腹股沟疝（UIH）的开放修复。使用LA体积和手术时间（LO）作为终点研究其安全性。还评估了手术疼痛和患者满意度。
方法：总共研究了438名成年患者，排除了体重不足的患者，那些需要任何额外的术中镇痛的人，多个程序，或数据不完整的记录。手术疼痛,患者满意度,从临床和手术记录的现有数据中回顾性研究了LO和LA体积。
结果：主要是男性人群（男性占93.2%），年龄范围为17-94岁，在60-69岁年龄段达到峰值。BMI范围为19-39kg/m2，BMI高于正常值62.8％。LO为13-100分钟(平均37分钟{SD=12}),每个患者使用45ml的平均LA体积(SD=11)。在BMI组中，LO（P=0.168）和患者满意度（P=0.388）无显著差异。尽管LA体积（P=0.011）和疼痛评分（P<0.001）显示出统计学上的显着差异，这些似乎没有临床相关性.在每个BMI组中，超过90％的人经历了轻度或无疼痛，并且在整个人群中只有一名患者报告了严重的疼痛。总的来说,在所有BMI组中，每位患者所需的LA体积都很低，并且剂量是安全的，其中有相当大比例（89％）的患者满意度评估为他们的经验≥90/100。
结论：与BMI无关，LA修复是安全且耐受性良好的。BMI不是将肥胖/超重个体排除在LA修复之外的可行原因。
方法：总共研究了438名成年患者，排除了体重不足的患者，那些需要任何额外的术中镇痛的人，多个程序，或数据不完整的记录。手术疼痛,患者满意度,从临床和手术记录的现有数据中回顾性研究了LO和LA体积。
结果：主要是男性人群（男性占93.2%），年龄范围为17-94岁，在60-69岁年龄段达到峰值。BMI范围为19-39kg/m2，BMI高于正常值62.8％。LO为13-100分钟(平均37分钟{SD=12}),每个患者使用45ml的平均LA体积(SD=11)。在BMI组中，LO（P=0.168）和患者满意度（P=0.388）无显著差异。尽管LA体积（P=0.011）和疼痛评分（P<0.001）显示出统计学上的显着差异，这些似乎没有临床相关性.在每个BMI组中，超过90％的人经历了轻度或无疼痛，并且在整个人群中只有一名患者报告了严重的疼痛。总的来说,在所有BMI组中，每位患者所需的LA体积都很低，并且剂量是安全的，其中有相当大比例（89％）的患者满意度评估为他们的经验≥90/100。
结论：与BMI无关，LA修复是安全且耐受性良好的。BMI不是将肥胖/超重个体排除在LA修复之外的可行原因。
