Local or general anesthesia for open hernia repair: a randomized trial

Area of Science:

• Surgical outcomes
• Anesthesiology
• Hernia repair

Background:

• Local anesthesia (LA) for hernia repair is often perceived as safer, less painful, and leading to faster recovery than general anesthesia (GA).
• Previous assumptions suggest LA offers advantages in postoperative pain, recovery time, and cost-effectiveness compared to GA for groin hernia surgery.

Purpose of the Study:

• To compare patient outcomes after primary groin hernia repair using local anesthesia (LA) versus general anesthesia (GA) in a randomized clinical trial.
• To evaluate cognitive function, pain, return to normal activities, and costs associated with LA and GA for hernia repair.

Main Methods:

• A randomized clinical trial involving patients with primary groin hernias undergoing repair by three surgeons.
• Outcome assessment included tests of vigilance, attention, memory, cognitive function, pain levels, return to activity, and economic costs.

Main Results:

• No significant differences in vigilance, divided attention, memory, or cognitive function were observed between LA and GA groups at 6, 24, or 72 hours postoperatively.
• While physical activity was impaired at 24 hours, return to social activities was similar. LA patients reported less pain on movement, but were less likely to recommend the procedure at 6 hours.
• General anesthesia (GA) hernia repair incurred 4% higher costs than local anesthesia (LA) repair.

Conclusions:

• There are no substantial differences in patient recovery following local anesthesia (LA) or general anesthesia (GA) for groin hernia repair.
• Patients should be offered a choice between local anesthesia (LA) and general anesthesia (GA) for their groin hernia repair procedure.