Title: Inguinal Hernia Repair: Comparison of Local Anaesthesia and Spinal Anaesthesia
Authors: Dr Amul Bhedi, Dr Sushil Damor, Dr Arnab Sarkar
DOI: https://dx.doi.org/10.18535/jmscr/v4i12.40
Abstract
Background: Inguinal hernia repair remains one of the most commonly performed operations worldwide. Today, local anaesthesia is the most preferred type over spinal and general anaesthesia in day-case hernia surgeries. Advantages being postoperative pain relief, early ambulation, shorter hospital stay and lesser costs. The condition of patient, surgeon’s experience and technical factors also play a role in this. Hence, this study will help us to discuss the factors that can help us to decide the effectiveness of local anaesthesia in day-case hernia surgeries.
Aims and Objectives: To determine whether local anaesthetic technique was an acceptable alternative to spinal anaesthesia for hernia repair, especially with regards to operative condition, patients & surgeons satisfaction, postoperative pain relief & complications and economical benefits.
Settings and Design: This was a prospective clinical study consisting of 60 patients undergoing Lichtenstein’s inguinal hernia repair, out of which 30 were given local anaesthesia and 30 were given spinal anaesthesia. All patients admitted in Department of General Surgery, SSG Hospital, Vadodara attached to the Medical College Baroda from September 2007 to January 2008.
Materials and Methods: Data was collected by meticulous history taking, careful clinical examination, appropriate radiological, haematological investigation, operative findings and follow-up of the cases.
Results: Immediate post-operative pain relief was more in LA group as compared to SA group, whereas after 24 hours, there was no significant difference in the pain scores between the two groups. Only three patients in SA group had micturition complaints post-operatively. Recovery from anesthesia was significantly faster for patients in the LA group than those in the SA group which had a mean interval of 4.1 hours. There was no significant difference in operative time and duration of hospital stay in the two groups.
Conclusion: It can be reliably concluded that local anaesthesia can be a preferred method in day-case hernia surgeries owing to its advantages. However, the experience of the surgeon and proper participation by the patient should also be looked upon in such cases.
Keywords: Inguinal hernia, Local anaesthesia, Spinal anaesthesia, Pain, Hernioplasty, Day-case surgery.
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