Groin Hernia Repair under Local Anesthesia in One Day Surgery-8-year Experience
Keywords:
Repair groin hernia under local anesthesia, Lichtenstien repair under local anesthesiaAbstract
Objective: Inguinal hernia repair is one of the most commonly performed operations world-wide. The objective of the present study was to evaluation of outcomes of open repair hernia under local anesthesia (LA) as a one-day surgery at Chonburi Hospital, using established surgical techniques.
Patient and Methods: A retrospective review of all adult inguinal hernia repairs under LA performed over an 8-year period (2011-2018) at Chonburi Hospital was done. There were 914 patients. Data collected included demographics, surgical techniques, early and late complications. LA techniques included the use lidocaine with adrenaline plus bupivacaine, in 3 steps: inguinal nerve blocking, subcutaneous infiltration and stepwise infiltration.
Results: Almost all patients (96%) were operated on as day case surgery. A few patients with functional class III were admitted for postoperative observation. Half of patients were between 60 to 80 years of age and 12% were functional class III. Primary indirect inguinal hernia was seen in 75% of patients, 5% had bilateral inguinal hernia and a few had incarcerated inguinal hernia. The most common operation was the Lichtenstein repair (98%). There were neither deaths nor side effects of anesthetic agents. Hematoma was the most common complication, requiring reoperation in a few patients. There were a few cases of chronic groin pain that were adequately treated by medications. The recurrence of hernia was very low.
Conclusion: Groin hernia repair under local anesthesia is a good option for any elective primary groin hernia repair, especially in patients with multiple underlying diseases, due to safety, low morbidity, and economic advantages.
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