Comparison of local versus spinal anesthesia in long standing open inguinal hernia repair

Abstract

Background: Hernias are among the oldest known afflictions of human kind and elective inguinal hernia repair is commonly performed operation in general surgery. General or spinal anesthesia are still the most common types of anesthesia being used in India. Studies comparing the recovery profiles of local, general and regional anesthesia show that local anesthesia is ideal for day care surgery.Methods: This study had included 60 cases of male single sided reducible indirect long standing (more than 5 years) inguinal hernia. Patients were divided randomly into two groups of 30 each named Group A and Group B. Patients in group A were subjected to inguinal hernia mesh repair under local anesthesia and patients in group B were subjected to inguinal hernia mesh repair under spinal anesthesia. Tension free Lichtenstein hernioplasty was done in both groups.Results: Time taken in local anesthesia is higher than spinal anesthesia. Intraoperative pain is higher in local anesthesia than spinal anesthesia. There is no difference on post-operative pain. Post-operative complications are more in spinal anesthesia group.Conclusions: Patient selection is very important and patient with long history should be avoided under local anesthesia.

A comparative study of Lichtenstein hernioplasty performed under spinal anaesthesia versus local anaesthesia in treatment of unilateral inguinal hernia

“…Urinary retention and headache was observed by Singh, Saxena et al, and Shafique et al in their study. 16,17,24 The occurrence of scrotal swelling was more in local anaesthesia which is similar to the findings by Shafique et al in their study. They observed scrotal swelling was more evident in local anaesthesia i.e.…”

“…15 They have concluded that local anaesthesia is better in terms of intra operative pain management but this result is contradicting the findings of Singh. 16 Postoperative pain is the most important variable and the soul of this study. Patient and surgeon satisfaction with acceptability depends upon postoperative pain.…”

“…15,[20][21][22][23][24] All of them have observed that postoperative pain is less with local anaesthesia but result not correlates with observation of Singh who had found postoperative pain is similar in both groups. 16 Postoperative pain control was better in local anaesthesia because pre-incisional field block with local anaesthesia reduces the build-up of nociceptor molecules and that also lasts for longer duration in the postoperative period. 25 Among the various postoperative complications, urinary retention, hypotension, headache, seroma, scrotal swelling was observed.…”

Current Concepts of Inguinal Hernia Repair

“…In a study randomly dividing 60 male patients with unilateral inguinal hernia into a group of Lichtenstein repair under local anesthesia and a group with spinal anesthesia, the time spent in local anesthesia was higher [44]. Intraoperative pain was higher in local anesthesia than with spinal anesthesia.…”

“…There was no difference in postoperative pain. Postoperative complications occurred more often in the spinal anesthesia group [44].…”