Spinal or local anesthesia in lichtenstein hernia repair: a randomized controlled trial

Area of Science:

• Surgical Anesthesiology
• Hernia Repair Techniques

Background:

• Anesthetic technique choice for inguinal hernia repair lacks standardized protocols.
• A discrepancy exists between scientific evidence and clinical practice regarding anesthesia for hernia repair.

Purpose of the Study:

• To compare the efficacy and outcomes of spinal anesthesia versus local anesthesia in patients undergoing primary inguinal hernia repair.

Main Methods:

• A multicenter prospective randomized clinical trial involving 100 patients with unilateral primary inguinal hernia.
• Patients were randomized to receive either spinal or local anesthesia.
• Postoperative follow-up included clinical examinations at 2 weeks and 3 months.

Main Results:

• Local anesthesia significantly reduced postoperative pain compared to spinal anesthesia (P = 0.021).
• Spinal anesthesia was associated with significantly higher rates of urinary retention (P < 0.001) and overnight admissions (P = 0.004).
• Operating time was significantly shorter with local anesthesia (P < 0.001).

Conclusions:

• Local anesthesia demonstrates superiority over spinal anesthesia for primary inguinal hernia repair.
• Local anesthesia is recommended as the preferred anesthetic method for these procedures.