Local versus general anesthesia for Shouldice repair of the inguinal hernia

Abstract

Since February 1992 local anesthesia (LA) has been used routinely for repair of inguinal hernias at our surgical department. All patients undergoing Shouldice repair of primary uncomplicated inguinal hernia between January 1990 and March 1993 were analyzed retrospectively concerning the need for analgesics, length of stay in hospital, and rate of complications. In addition 50 patients after LA and 50 patients after general anesthesia underwent prospective pain analysis using a visual analogous score and spirometric tests (FEV1 and peak flow). After LA we found less need of analgesics, shorter hospital stays, and fewer complications. The pain level was lower, and ventilatory function was less affected. Repair of the inguinal hernia using LA is a safe method to lower the risk of the operation and to improve the patient's comfort without increasing complications.

Inguinal Hernia Repair: Local or General Anaesthesia?

“…There was no statistically significant difference in the incidence of complications between the two study groups except for the higher incidence of urinary retention in the GA group compared to LA group. Comparison of general and local anaesthesia either in randomised 36,37 or non-randomised studies 38,39 has shown a similar incidence of urinary retention between local and general anaesthesia in all but one study. 39 A large review of post herniorrhaphy urinary retention suggests that the incidence of urinary retention is lower with local anaesthetic inguinal hernia repair compared to general and regional anaesthesia.…”

“…Comparison of general and local anaesthesia either in randomised 36,37 or non-randomised studies 38,39 has shown a similar incidence of urinary retention between local and general anaesthesia in all but one study. 39 A large review of post herniorrhaphy urinary retention suggests that the incidence of urinary retention is lower with local anaesthetic inguinal hernia repair compared to general and regional anaesthesia. 40 There was no statistically significant difference in the incidence of chronic groin pain between the general and local anaesthetic groups.…”

Appendectomy Realized Con Local Anesthesia: A Case Report

“…The anesthesiologists had handled the peripheral nerves in the members but not in the abdomen because they have had the epidural or either subarachnoid anesthesia, 7 However, sometimes we have older patients with high surgical risk to operate, so have been sought more secure anesthetic techniques. 8 Over the years the techniques of abdominal peripheral block have been refined, 9 For more than forty years, inguinal repair has been performed local anesthesia, offering less postoperative pain 10,11,12 being an approach simpler and secure, the procedures performed have been used with good results, offering the advantages in addition to producing less postoperative pain. 13 In our hospital, Dr. Garrido has performed more than 100 appendectomy with local anesthesia with the same results as we described below, so we decided to report this case.…”

A Comparative Study of Repair of Inguinal Hernias by Shouldice Technique Vis-a-Vis Bassinis Technique

“…Bilateral hernias were operated in the same hospitalization 48-72 hours apart. This practice is followed in Shouldice Clinic Toronto and simultaneous repair not done so that if one side develops infection the other does not follow suit and secondly since most repairs are done under local anaesthesia, a simultaneous procedure would exceed the total permissible dose of lignocaine [5,6]. A total of 6 recurrent hernias were tackled.…”