Should general anesthesia or spinal anesthesia with ketofol sedation be applied in umbilical hernia operations?

Introductıon: In our study, we aimed to find the most appropriate anaesthesia management by comparing general anaesthesia and spinal anaesthesia under ketofol (ketamine-propofol combination) sedation in terms of intraoperative and postoperative haemodynamics, complications and cost in patients undergoing umbilical hernia operation. Materıals and Methods: Fifty patients who were between 18-65 years old, ASA 1-2 that would undergo umblical hernia repair operations were include. The patients were divided into 2 groups with a computer-assisted randomization program. In the general anesthesia group, a total of 3 patients were exluded due to intraoperative complications (n=2), and surgical changes (n=1). A total of 3 patients were excluded from the study in the spinal anesthesia group; due to intraoperative complications (n=2) and surgical changes (n=1). The patients who underwent spinal anesthesia were named Group 1(n=22) and the patients who underwent general anesthesia were named Group 2 (n=22). Both groups were premedicated with 0.03 mg/kg midazolam. In the spinal anaesthesia group (Group 1), each patient was sedated with ketofol after administration of spinal anesthesia with 15 mg heavy-bupivacaine. In the general anaesthesia group (Group 2), all patients were anaesthetised with sevoflurane (Sevorane) inhalation and BIS (VISTA covidien, USA) of 40-60 in the intraoperative period after routine anaesthesia induction. In both groups were recorded at regular intervals Pulse rate, systolic arterial pressure, diastolic arterial pressure, mean arterial pressure, postoperative Aldrete score and operative time. Numeric pain score (NRS) was used in the postoperative period. Patients were transferred to the service when the postoperative Aldrete score reached 9 points. Conclusion: There was no statistically significant difference between the groups in terms of gender, age, American Society of Anaesthesiologists (ASA) score and operative time. Postoperative Aldrete mean value was statistically significantly lower in Spinal group. Cost was found to be significantly lower in Group 1 than in Group 2. There was no difference between the groups in terms of hospitalisation. There was no difference in postoperative nausea and vomiting. There was no difference in NRS pain score between the groups. Spinal anaesthesia in cases of umbilical hernia is very advantageous in terms of cost and can be considered as the first choice in appropriate cases.