A Prospective Comparative Study of Inguinal Hernia Repair under Local Anesthesia versus Spinal Anesthesia

Abstract

Background: Inguinal hernia repair is one of the most commonly performed surgical procedures worldwide. The selection of an appropriate anaesthetic technique significantly influences perioperative safety, postoperative pain, recovery, and patient satisfaction. This study aimed to compare the effectiveness and safety of local anaesthesia versus spinal anaesthesia in patients undergoing elective inguinal hernia repair.

Materials and Methods: This prospective comparative study included 120 patients undergoing elective open inguinal hernia repair, divided into two groups: local anaesthesia (n = 60) and spinal anaesthesia (n = 60). Demographic characteristics, intraoperative parameters, postoperative pain scores, analgesic requirements, recovery characteristics, anaesthesia-related complications, and patient satisfaction were compared between the groups.

Results: The mean duration of surgery was 48.60 ± 9.25 minutes under local anaesthesia and 46.80 ± 8.75 minutes under spinal anaesthesia. At six hours postoperatively, mean VAS scores were 2.80 ± 1.10 and 3.85 ± 1.15, respectively. Time to first rescue analgesia was longer under local anaesthesia (5.80 ± 1.65 versus 3.90 ± 1.40 hours). Local anaesthesia was associated with earlier mobilisation (3.20 versus 6.40 hours), shorter hospital stay (18.50 versus 27.80 hours), and lower incidences of hypotension (3.33% versus 20.00%) and urinary retention (1.67% versus 15.00%). Patient satisfaction was also higher under local anaesthesia.

Conclusion: Local anaesthesia may provide favourable postoperative analgesia, faster recovery, fewer complications, and greater patient satisfaction compared with spinal anaesthesia, making it a feasible alternative for appropriately selected patients undergoing elective inguinal hernia repair.