Comparison Outcomes of Local Anesthesia and Spinal Anesthesia in Tension-Free Herniorrhaphy: Randomized Controlled Trial

Abstract

Objective: To compare operative pain, operating time, patient satisfaction, number of days in the hospital, complications and cost between spinal and local anesthetic techniques for inguinal hernia repair.
Methods: Seventy patients underwent tension-free herniorrhaphy at Lat Krabang Bangkok Hospital were randomized to local and spinal anesthesia groups. Intraoperative, 6- and 12-hour postoperative pain, operating time, patient satisfaction, number of days in the hospital, post operation analgesic drug, complications, and cost were compared between the two groups.
Results: All operation were successfully completed without changing to another anesthetic method. The average pain for inguinal repair in the local anesthesia group was higher than the spinal anesthesia (1.23 ± 0.69 and 0 ± 0; p <0.05). There was no complication in both groups. Local anesthesia herniorrhaphy had the advantage over the spinal anesthesia herniorrhaphy in terms of less duration in the operating room, less cost of surgery, less opioid use, more patient satisfaction (all p <0.05).
Conclusion: Pain score is significantly higher in the local anesthesia group (p <0.05), but the pain did not affect the success of the surgery. Local anesthesia herniorrhaphy also benefit in term of duration in operating room, cost of surgery, opioid use and patient satisfaction. Therefore, this technique may be recommended as the first choice in inguinal hernia repair.