A Comparison of local and spinal block for elective inguinal hernia repair at 50 Pansa Mahavajiralongkorn Hospital: Retrospective Cohort Study

Abstract

This retrospective descriptive comparative study aimed to compare the incidence of postoperative complications, operative time, length of hospital stay, and treatment costs between elective inguinal hernia repair using local anesthesia and spinal block. The sample consisted of male patients who underwent the surgery at 50th Anniversary Mahavajiralongkorn Hospital totaling 135 cases, divided into the local anesthesia (LA) group (68 cases) and the spinal block (SB) group (67 cases). The research instrument's content validity (IOC) was 0.83, and the inter-observer reliability (ICC) ranged from 0.94 to 0.97. Data were analyzed using the Mann-Whitney U test, independent t-test, and multivariable logistic regression to control for confounding variables.

               The results revealed that the LA group had a significantly shorter length of hospital stay than the SB group (p <0.001) with a large effect size (Effect size r = 0.86), and significantly lower treatment costs (p <0.001), while the operative time showed no significant difference (p =0.127). Regarding the incidence of complications, after adjusting for age, body weight, body mass index (BMI), and hernia site, it was found that the SB group had a 9.59 times higher risk of overall complications than the LA group (p =0.006) and a 13.03 times higher risk of hypotension (p =0.019). The study suggests that surgery under local anesthesia is safe and significantly reduces both treatment duration and costs. Therefore, it may be considered as an initial option to support One Day Surgery protocols, which will further enhance the efficiency of medical resource management.