Comparison of Local Versus General Anesthesia in Open Inguinal Hernioplasty: A Prospective Study on Postoperative Outcomes and Cost-Effectiveness:

Chainarong Phalanusitthepha; Boondee Kitkanphatthanalert; Chatbadin Thongchuam; Thawatchai Akaraviputh; Sukunya Jirachaipitak; Tharathorn  Suwatthanarak

doi:10.33192/smj.v78i4.280214

Authors

Chainarong Phalanusitthepha Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Boondee Kitkanphatthanalert Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Chatbadin Thongchuam Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Thawatchai Akaraviputh Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Sukunya Jirachaipitak Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Tharathorn Suwatthanarak Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

DOI:

https://doi.org/10.33192/smj.v78i4.280214

Keywords:

Hernioplasty, Inguinal hernia, Local anesthesia, Day surgery, Cost-effectiveness

Abstract

Objective: This study evaluates whether performing open inguinal hernia repair under local anesthesia with sameday discharge is comparable to general anesthesia with inpatient admission, with respect to postoperative outcomes, recovery time, and healthcare costs.

Materials and Methods: This prospective cohort study was conducted at Siriraj Hospital and included 30 adults undergoing unilateral open inguinal hernioplasty. Patients were allocated to either local anesthesia with same-day discharge (n=15) or general anesthesia with inpatient admission (n=15). Postoperative pain, recovery time, operative efficiency, complications, and total hospital costs were assessed.

Results: Postoperative pain at rest at 8 and 24 hours was lower in the LA group compared with the GA group (1.93±1.10 vs 2.53±1.55 p=0.233, 0.87±0.83 vs 1.80±1.65 p=0.032). Patients in the LA group resumed normal activities significantly earlier, and total hospital costs were significantly lower (1.00+0.54 vs 1.40+0.51 p = 0.022, 13,453 THB vs. 41,226 THB; p<0.001). Operative time, theater time, complications, and patient demographics (age, BMI, ASA classification) were comparable between groups.

Conclusions: Open inguinal hernioplasty under local anesthesia in a day-surgery setting demonstrated clinical outcomes comparable to those of general anesthesia with inpatient admission. Additionally, this approach was associated with faster functional recovery and significantly reduced hospital costs. Local anesthesia represents a safe, efficient, and cost-effective alternative for appropriately selected patients.

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