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Comparison between monitored anesthesia care with remifentanil under ilioinguinal hypogastric nerve block and spinal

Yun-Sic Bang1, Chunghyun Park, Su-Yeon Lee

  • 1Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.

Korean Journal of Anesthesiology
|June 7, 2013
PubMed
Abstract

Insights

Ilioinguinal-hypogastric nerve block (IHNB) with monitored anesthesia care (MAC) and remifentanil infusion offers better patient and surgeon satisfaction for inguinal herniorrhaphy compared to spinal anesthesia. This technique provides hemodynamic stability and fewer side effects.

Area of Science:

  • Anesthesiology
  • Surgical Procedures
  • Pain Management

Background:

  • Monitored anesthesia care (MAC) is increasingly utilized for various procedures.
  • Comparing spinal anesthesia with IHNB under MAC for inguinal herniorrhaphy is crucial.

Purpose of the Study:

  • To compare spinal anesthesia and IHNB with remifentanil-infused MAC for inguinal herniorrhaphy.
  • To evaluate outcomes including hemodynamic stability, patient comfort, and satisfaction.

Main Methods:

  • Fifty patients were randomized into spinal anesthesia (Group S) or IHNB with MAC (Group M).
  • Remifentanil infusion was titrated in Group M based on respiratory rate and discomfort.
  • Hemodynamic values, oxygen saturation, BIS, OAA/S, VAS, and satisfaction were assessed.

Main Results:

  • No significant differences in BIS or OAA/S between groups.
  • Group M demonstrated stable hemodynamics; transient respiratory depression occurred without desaturation.
  • Higher patient and surgeon satisfaction and lower urinary retention rates were observed in Group M.

Conclusions:

  • IHNB with MAC and remifentanil is a safe and effective alternative for inguinal herniorrhaphy.
  • This method offers hemodynamic stability, reduced side effects, and enhanced satisfaction.
  • Suitable for outpatient settings and patients unsuitable for spinal or general anesthesia.
Keywords:
Inguinal herniorrhaphyMonitored anesthesia careRemifentanilSpinal anesthesia

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