Inguinal Hernia Repair with Local Anesthesia in the Outpatient—10 Year Experience

Abstract

Objective: To demonstrate the feasibility of inguinal hernia repair with local anesthesia in an outpatient regime, with safety, efficacy and short learning curve. Methods: We prospectively evaluated 1186 patients undergoing inguinal hernia repair under local anesthesia on an outpatient basis between November 2004 and March 2014. Of the total number of hernias surgically treated in this period, 755 were operated on the right, 394 on the left and 37 bilateral. We used clinical, surgical and psychosocial criteria for inclusion in the procedure. The parameters for exclusion were complex, irreducible or recurrent hernia, obesity (BMI greater than 30 kg/m 2), patient's refusal and psychiatric disorder. All patients underwent elective surgery and were analyzed regarding surgical outcome, complications and hospital stay. Results: All operations were completed successfully. In no case there was a need to change the anesthetic method. Surgical time was similar to that conducted with other methods of anesthesia and there were no cases of adverse effects of local anesthetics. Intra-operative complications amounted to approximately 2.64%. There was no need for hospital admissions greater than 24 hours. Conclusion: The procedure is feasible and causes no perioperative significant pain, is safe, can be performed by residents under supervision, has satisfactory patient acceptance and complications similar to those observed in a conventional herniorrhaphy, allowing lower time and cost of hospitalization and faster access to treatment.

Network meta-analysis of urinary retention and mortality after Lichtenstein repair of inguinal hernia under local, regional or general anaesthesia

“…A total of 46 studies reported mortality within 90 days. The studies covered 10 332 patients: 7976 had LA, 722 regional anaesthesia and 1634 GA. Methods of follow‐up included clinical examination, telephone call, questionnaire , contact with family doctor and electronic patient data management.…”

“…). A total of 53 studies were included: 12 RCTs and 41 cohort studies, with either a prospective or retrospective study design. Study characteristics are summarized in Table S1 (supporting information).…”

“…The studies covered 10 332 patients: 7976 had LA, 722 regional anaesthesia and 1634 GA. Methods of follow‐up included clinical examination, telephone call, questionnaire , contact with family doctor and electronic patient data management. Six studies did not report methods of follow‐up. Median follow‐up was 36 days (range 6 h to 90 days), and the median rate of completion of follow‐up was 100 (range 82 − 100) per cent.…”

Local anesthesia for treatment of hernia in elder patients: Levobupicavaine or Bupivacaine?

“…This type of anesthesia has significantly improved the treatment of inguinal hernia, significantly reducing recurrences, complications, recovery time and return to normal working activities. Hernia surgery should be approached according to a technique as simple and safe as possible that is at the same time accepted by the patient and easily realizable by the surgeon [ 1 , 2 ]. It is important find solutions which can be adapted to each individual patient, combining experience and new technologies.…”

Comparative study between Levobupivacaine and Bupivacaine for hernia surgery in the elderly

“…Hernia surgery should be approached according to a technique as simple and safe as possible that is at the same time accepted by the patient and easily realizable by the surgeon [ 1 ]. Inguinal hernioplasty is now the most performed surgery in the departments of general surgery [ 2 ]. For this reason it is necessary to find solutions which can be adapted to each individual case, combining experience and innovation.…”