Spinal or local anesthesia in lichtenstein hernia repair: a randomized controlled trial.

Abstract

BACKGROUND:

With established protocols lacking, the choice of anesthetic technique remains arbitrary in inguinal hernia repair. Well-designed studies in this subject are important because of the gap or discrepancy between available scientific evidence and clinical practice.

METHODS:

Between August 2004 and June 2006, a multicenter prospective clinical trial was performed in which 100 patients with unilateral primary inguinal hernia were randomized to spinal or local anesthesia. Clinical examination took place within 2 weeks postoperatively and at 3 months in the outpatient clinic.

RESULTS:

Analysis of postoperative visual analogue scale scores showed that patients operated under local anesthesia had significant less pain shortly after surgery (P = 0.021). Significantly more urinary retention (P < 0.001) and more overnight admissions (P = 0.004) occurred after spinal anesthesia. Total operating time is significantly shorter in the local anesthesia group (P < 0.001). No significant differences were found between the 2 groups with respect to the activities of daily life and quality of life.

CONCLUSIONS:

Our study provides evidence that local anesthesia is superior to spinal anesthesia in inguinal hernia repair. Local anesthesia in primary, inguinal hernia repairs should be the method of choice.

• Authors: Ruben N van Veen, Chander Mahabier, Imro Dawson, Wim C Hop, Niels F M Kok, Johan F Lange, Johannus Jeekel
• Journal: Annals of surgery (Ann Surg) Vol. 247 Issue 3 Pg. 428-33 (Mar 2008) ISSN: 0003-4932 [Print] United States
• PMID: 18376185 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial)

Topics

• Activities of Daily Living
• Adult
• Aged
• Aged, 80 and over
• Anesthesia, Local
• Anesthesia, Spinal
• Female
• Hernia, Inguinal (surgery)
• Humans
• Male
• Middle Aged
• Pain Measurement
• Prospective Studies
• Quality of Life
• Time Factors