Clinical effects of intrathecal fentanyl on shoulder tip pain in laparoscopic total extraperitoneal inguinal hernia repair under spinal anaesthesia: A double-blind, prospective, randomized controlled trial

Abstract

Objective: The study evaluated the clinical intraoperative effects of intrathecal administration of fentanyl on shoulder tip pain in patients undergoing laparoscopic total extraperitoneal inguinal hernia repair (TEP) under spinal anaesthesia. Methods: Patients undergoing TEP were allocated in a double-blinded, prospective, randomized manner to two groups. Spinal anaesthesia was induced by intrathecal administration of 2.8 ml of 0.5% hyperbaric bupivacaine (14 mg) in the control group and with 2.6 ml of 0.5% hyperbaric bupivacaine (13 mg) and 10 mg fentanyl (0.2 ml) in the experimental group.Results: The quality of muscle relaxation, adequacy of operative space and incidence of pneumoperitoneum were similar in the two groups (n ¼ 36 per group). Compared with the control group, the experimental group had significantly fewer cases of hypotension (12 [

Laparoscopic total extraperitoneal repair under spinal anesthesia versus general anesthesia: a randomized prospective study

“…Distension of intracranial vessels and an increase in brain blood flow can play a primary role in postdural pain headache formation 34. The headache rate in TEP repair under SA was reported to be between 0% and 9.7% 13,15,18. Only 2 patients (8%) in the SA group experienced headaches in the present study.…”

“…Its incidence in TEP repairs under GA is between 4.2% and 12.0%27,28,30 and under SA between 3.33% and 18.05% 13,18. Ismail et al compared mesh-fixed and non mesh fixed patients in their retrospective clinical study, and the nonfixed group under GA had no urinary retention.…”

“…Sung et al reported that the use of intrathecal fentanyl during TEP repair under SA decreased the incidence of hypotension 18. Sinha et al reported a hypotension rate of 15.63% 15.…”

Laparoscopic appendectomy under spinal anesthesia with dexmedetomidine infusion

“…In comparison to previous studies [4,14], LA under spinal anesthesia differed markedly from laparoscopic hernia repair under regional anesthesia. During laparoscopic hernia repair, carbon dioxide gas is introduced into the extraperitoneal space, not the intra-abdominal cavity.…”

Laparoscopic Abdominal Surgery Under Regional Anesthesia: A Retrospective Evaluation

“…Çalışmamızdaki ÜR insidansı, önceki raporlarla benzerdi (10,14,20). SA'ya bağlı baş ağrısı insidansı laparoskopik cerrahi sonrası %0-8,3 olarak bildirilmektedir (14,19,20,26). Baş ağrısı, küçük çaplı atravmatik spinal iğnelerin kullanıma girmesiyle önemli oranda azalmasına rağmen birkaç güne kadar uzayabilmekte ve hastaneden çıkışı geciktirebilmektedir (14,34).…”