A Comparative Study of Lichtenstein Tension Free Hernia Repair in Local Anaesthesia versus Spinal Anaesthesia
Journal Title: Saudi Journal of Medicine - Year 2018, Vol 3, Issue 7
Abstract
Abstract:The incidence of inguinal hernia is very common especially in older individuals. Often patients are unaware of the presence due to absence of any symptoms unless detected accidentally or detected in those causing presence of pain or other symptoms. The anterior open inguinal hernia repair with mesh was described by Lichtenstein in 1989. This tension free operation has become popular. We in the present study operated on the patients with uncomplicated unilateral inguinal hernia with Lichtenstein tension free technique under Local Anesthesia and Spinal Anesthesia to evaluate their outcomes. Methods: This prospective study was conducted in the Department of General Surgery, Prathima Institute of Medical Sciences, Naganoor, Karimnagar. A total of 74 patients admitted to the hospital with the diagnosis of uncomplicated inguinal hernia were included in the study. They were divided into two groups Group I (LA) included 36 patients and group II [GA] 38 patients. The investigations required as routine for diagnosis and to test the sensitivity to the local anesthetic night before surgery. Lichtenstein tension free hernioplasty is performed irrespective of type of anesthesia. The postoperative pain was measured with the Visual analogue scale (VAS) at 4h, 8h, 12h & 24h. Results: Mean time taken for duration of surgery in LA group is 58.8 + 6.02 minutes & in SA group is 56.6 + 6.74 minutes. P = 0.246 not significant. Mean time spent in operating room in LA group is 68.1 + 6.35 minutes & in SA group is 76.4+6.52 minutes with a significant P value of <0.01. The mean VAS score at 4h, 8h, 12 h, & 24h for LA group was low when compared to the SA group. The maximum VAS score was observed at 8h in both the groups and less in LA group at 3.13 ± 1.26 as compared to SA group 4.31 ± 1.66 at 12 hours also VAS was less in LA at 1.97 ± 1.02 as compared to SA 3.15 ± 1.88. Conclusion: From our study it is observed that Lichtenstein tension free hernioplasty done under local anesthesia offers following several advantages over spinal anesthesia and it is Safer even in the patients with medical comorbidities and on antiplatelet therapy. Therefore local anesthesia may be considered as the anesthesia of choice for Lichtenstein tension free hernioplasty for an uncomplicated, primary, inguinal hernia. Keywords: Lichtenstein Tension Free hernioplasty, Local Anesthesia, General Anesthesia.
Authors and Affiliations
Lanka Shivaramprasad
Keywords
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