Inguinal hernia repair is one of the most common procedures in general surgery. All
anesthetic methods can be used in
inguinal hernia repairs.
Local anesthesia for groin
hernia repair had been introduced at the very beginning of the last century, and gained popularity following the success reports from the Shouldice Hospital, and the Lichtenstein
Hernia Institute. Today,
local anesthesia is routinely used in specialized
hernia clinics, whereas its use is still not a common practice in general hospitals, in spite of its proven advantages and recommendations by current
hernia repair guidelines. In this review, the technical options for local anaesthesia in groin
hernia repairs, commonly used local anaesthetics and their doses, potential complications related to the technique are evaluated. A comparison of local, general and
regional anesthesia methods is also presented. Local anaesthesia technique has a short learning curve requiring simple training. It is easy to learn and apply, and its use is in open anterior repairs a nice way for health care economics.
Local anesthesia has been shown to have certain advantages over general and
regional anesthesia in
inguinal hernia repairs. It is more economic and requires a shorter time in the operating room and shorter stay in the institution. It causes less
postoperative pain, requires less
analgesic consumption; avoids
nausea,
vomiting, and
urinary retention. Patients can mobilize and take oral liquids and solid foods much earlier. Most importantly,
local anesthesia is the most suitable type of
anesthesia in elder, fragile patients and patients with ASA II-IV scores.