Comparative Analysis Of Local And Combined Anaesthesia For Tension-free Inguinal Hernia Repair

Objective:Inguinal hernia is a common disease in general surgery.As aging of population,the incidence rate have been increasing.Tension free hernia repair is reported to have advantages of less postoperation pain,quicker recovery, lower recurrence rates,etc,and been accepted in all over the world.Alternative anaesthetic methods for tension free hernia repair contain local,intravertebral or general anaesthesia.With established protocols lacking,the choice of anaesthetic technique remains arbitary in inguinal hernia repair.The aim of this study was to analyze the safety and efficacy of local anaesthesia and combined anaesthesia(combined spinal-epidural anaesthesia) in tension free repair of inguinal hernia,so as to seek rational anaesthesia method.Methods:One hundred patients,on whom tension free hernia repair had been performed at Shanxi Province Peoples Hospital affiliated to Medical University between September2013 and September 2015,were retrospective examined.The patients with direct hernia are20 cases,and 80 cases with indirect hernia.According to anaesthesia applied,the patients were divided into two groups:local anaesthesia group(50 cases) and combined anesthesia group(50 cases).The primary endpoints were operation and anaesthesia duration,ambulation time,postoperative hospital stay,hospital costs(excluding patch cost),visual analogue pain score(VAS) at 2,6,12,and 24 h postoperation,early period postoperative complications,recurrence rates.Results:Compared to combined anaesthesia group,local anaesthesia group has significant difference in operation and anaesthesia duration,ambulation time,postoperative hospital stay,hospital costs(p<0.05),with statistical significance.The occurrence rates of postoperative nausea,vomiting,urinary retention in local anaesthesia group were lower than that in combined ananesthesia group(p<0.05),with statistical significance.No significant differences were found between two groups with respect to postoperative incision and scrotum complications and recurrence rate(p>0.05).Although visual analogue pain score(VAS)values at 2,6,12,and 24 h postoperation were lower than combined group,the differernce between two groups were not significant.Conclusion:Compared to combined anaesthesia,tension free inguinal hernia repair under local anaesthesia is simple,safe,ecomocial, and worthy of clinical promotion.