REVIEW   

Minerva Anestesiologica 2022 July-August;88(7-8):604-14

DOI: 10.23736/S0375-9393.22.16126-2

Copyright © 2022 EDIZIONI MINERVA MEDICA

lingua: Inglese

Comparative benefits of local anesthesia and spinal anesthesia in adult open inguinal hernia: a meta-analysis of clinical randomized controlled trials

Shuangfa MAO ^{1, 2}, Shuai CHEN ^{1, 2}, Linghong GUO ², Qian LUO ^{1, 2}, Yin LIU ^{1, 2, 3} ✉

¹ Department of Basic Medical Sciences, Sichuan Vocational College of Health and Rehabilitation, Zigong, China; ² Department of Pharmacology, West China School of Basic Sciences and Forensic Medicine, Animal Research Institute, Sichuan University, Chengdu, China; ³ Department of Anesthesiology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China

INTRODUCTION: The aim of this meta-analysis is to systematically evaluate the clinical effects of local anesthesia and spinal anesthesia in the treatment of open inguinal hernia in adults, and provide theoretical evidence for clinical choice.
EVIDENCE ACQUISITION: We searched the PubMed, Embase and The Cochrane Library, and collected published clinical randomized controlled trials (RCTs) on the efficacy and safety of local anesthesia and spinal anesthesia for open inguinal hernia surgery in adults. According to the inclusion and exclusion criteria, the literature was screened and the data was analyzed by using Review Manager.
EVIDENCE SYNTHESIS: A total of 11 RCT studies were included in the meta-analysis, with 591 cases in the local anesthesia group and 584 cases in the spinal anesthesia group. Our results showed that compared with the spinal hernia repair group, the hernia repair group under local anesthesia had a lower incidence of headache (RR=0.11, 95% CI: 0.03, 0.46), urinary retention (RR=0.13, 95% CI: 0.05, 0.32) and postoperative pain score at 12 hours (SMD=-1.09, 95% CI: -1.41, -0.76), and a higher anesthesia efficiency (RR=1.09, 95% CI: 1.03, 1.16) and satisfaction rate (RR=1.12, 95% CI: 1.01, 1.24). There was no statistically significant difference between the two groups in operation time, the incidence of intraoperative pain, hematoma, infection, postoperative chronic pain in the groin area, and testicular pain/swelling.
CONCLUSIONS: In open inguinal hernia surgery for adults, local anesthesia is better than spinal anesthesia with lower incidence of adverse events, higher efficacy and satisfaction.

KEY WORDS: Hernia; Groin; Local anesthesia; Spinal anesthesia; Treatment outcome; Safety; Meta-analysis