A comparison of general versus local anesthesia during inguinal herniorrhaphy

The current study was done to compare the hemodynamic changes, recovery events and economic impact of elective inguinal herniorrhaphy performed with general anesthesia (GA) or regional field block (RB) in 20 patients (American Society of Anesthesiology class I). In the GA group, anesthesia was induced with thiopental and the trachea was intubated after intravenous administration of 0.08 milligrams per kilogram of vecuronium. GA was maintained with 1.2 +/- 0.25 per cent enflurane in 50 per cent nitrous oxide and oxygen, and ventilation was controlled to keep PECO2 at 36 +/- 2 millimeters of mercury. Anesthesia in the RB group was accomplished by local injection of 3.5 +/- 0.5 milligrams per kilogram of 0.5 per cent bupivacaine. In each patient, a suprasternal ultrasonic Doppler probe was used to measure cardiac output before induction of anesthesia, during and after operation. Total peripheral resistance was calculated from mean arterial pressure and cardiac output. There were no statistically significant differences between cardiac output, mean arterial pressure, total peripheral resistance and heart rate in the two groups at any time period during the study. Patients in the RB group did not require parenteral medication for relief of postoperative pain, whereas all those in the GA group did. Significant cost benefits were realized by the RB group because of elimination of general anesthetic and reduction of recovery room fees.