METHODS: The study was a pilot retrospective chart review on patients who underwent a Shouldice Repair from November 2023 to December 2023. This study compared individuals receiving an ilioinguinal-iliohypogastric nerve block with local anesthesia and fentanyl analgesia to those who received local anesthesia and fentanyl analgesia, by manually matching 1:1 on 12 demographic and intraoperative characteristics. Comparison between groups was performed using chi-square/Fisher Exact test for categorical and t-test/Mann-Whitney test for numerical variables depending on data distribution. Multivariable regression analysis was used to examine predictors of intraoperative use of fentanyl.
RESULTS: In this study 50 matched pairs of unilateral primary inguinal hernia patients were analyzed. The ilioinguinal-iliohypogastric nerve block patients had lower recorded intraoperative fentanyl (85mcg less than control, p < .001) and dimenhydrinate (13 mg less than control, p < .001) than the control group patients. No differences were found in postoperative day 0 to 3 for acetaminophen, non-steroidal anti-inflammatory drug, and opioid consumption between the patients who did receive an ilioinguinal-iliohypogastric nerve block prior to surgery and those that did not.
CONCLUSIONS: The administration of an ilioinguinal-iliohypogastric nerve block prior to primary inguinal hernia repair using a Shouldice Repair is associated with a significantly lower intraoperative fentanyl consumption compared to non-administration.
方法:该研究是对2023年11月至2023年12月接受Shouldice修复的患者进行的回顾性回顾性分析。这项研究比较了接受局部麻醉和芬太尼镇痛的髂腹股沟-髂腹下神经阻滞的个体与接受局部麻醉和芬太尼镇痛的个体,通过手动匹配12个人口统计学和术中特征的1:1。根据数据分布,使用卡方/Fisher精确检验进行分类和t检验/Mann-Whitney检验进行组间比较。多变量回归分析用于检查术中使用芬太尼的预测因素。
结果:在这项研究中,分析了50对匹配的单侧原发性腹股沟疝患者。髂腹股沟-髂腹下神经阻滞患者术中芬太尼的记录较低(比对照组少85mcg,p<.001)和dienhydrinate(比对照少13毫克,p<.001)高于对照组患者。对乙酰氨基酚在术后第0天至第3天未发现差异,非甾体抗炎药,手术前接受髂腹股沟-髂腹下神经阻滞的患者与未接受的患者之间的阿片类药物消耗量。
结论:在原发性腹股沟疝修补术前使用Shouldice修补术进行髂腹股沟-髂腹下神经阻滞与术中芬太尼消耗量显著降低相关。