Prospective significance of local anesthesia for lichenstien tension free mesh hernioplasty compared to regional anesthesia

Background: Hernia is a common surgical problem which requires good surgical skill as well as good knowledge about anatomy and various repair of hernia. The choice and delivery of safe effective anesthesia for inguinal herniorraphy is based on the type and extent of surgical procedure, concomitant medical diseases, side effects of anesthetic agents and organ function. An increased attention has been paid to the provision of stress free anesthesia and surgery in order to reduce postoperative pain and morbidity. These considerations must be balanced with the direct cost of medical procedures including anesthetic service and pre operative examination. Local anesthesia is an acceptable alternative to spinal anesthesia for hernioplasty especially with regard to operative condition, patient’s surgeon’s satisfaction, post operative pain relief, complications and effectiveness. This study focus on the efficacy of using local anesthesia in comparison to regional anesthesia in repairing uncomplicated inguinal hernia by measuring post- operative pain and post operative complications and to check the feasibility of using local anesthesia for short stay surgery.

Materials & Method: Sixty patients were randomized to study & control group. In control group spinal anesthesia was used for hernioplasty whereas in the study group local anesthesia was used. Both groups were further compared for intra-operative, immediate and delayed postoperative complications.

Results: Both local & spinal anesthesia can be used for hernia repair on short stay bases, but spinal anesthesia has shown higher complication rates. Significant increase in general complications like hypotension, urinary retention & headache were seen in the patients where spinal anesthesia was used. Whereas local complications like seroma, hematoma, scrotal edema & recurrence were similar in both the groups.

Conclusion: Local anesthesia is best suitable for short stay surgery when compared to spinal anesthesia with less immediate and post operative complications. When short stay service is implemented there will be considerable benefits to the hospital service & to the patients.