A step towards Lichtenstein repair as a day care surgery: spinal versus local anaesthesia

Abstract

Background: Inguinal hernia repair includes 15% of the procedures in general surgery. Until now the conventional post-operative protocol was to keep patient admitted till the patient was completely mobilized and fit to return to daily activity. This leads to unnecessary occupancy of hospital beds and increased financial burden to the patients. Therefore, day care surgery or short stay surgery is the need of the hour, in which local anaesthesia can play a major part. The aim of this study was to analyse the outcomes of inguinal hernia repair with special emphasis on the use of local and spinal anaesthesia and to find out which among the two was regarded as an effective method.Methods: A randomised control trial was conducted at MGM medical hospital, Aurangabad over a duration of two years (November 2016 to October 2018) where 100 patients of uncomplicated unilateral inguinal hernia were included. 50 patients were given spinal anaesthesia and 50 patients were given local anaesthesia. Intra-operative and post-operative complications and recovery was noted.Results: The duration of surgery, post-operative pain and complications were significantly lesser in local anaesthesia group (p<0.0001). Post-operative mobilisation, micturition and starting of oral diet was significantly earlier in patients receiving local anaesthesia (p<0.0001). The patients in the local anaesthesia group were discharged sooner than the spinal anaesthesia group (p<0.0001).Conclusions: Thus, local anaesthesia has a major role in establishing inguinal hernia repair as a day care or short stay surgery. Local anaesthesia is a safe, efficient and cost-effective option for inguinal hernia repair compared to spinal anaesthesia in terms of patient benefits and patient satisfaction.