BENEFITS OF LOCAL ANAESTHETIC FOR INGUINAL HERNIA REPAIR

There has been a renewed interest in the use of local anesthesia (LA) for inguinal hernia repair. Most inguinal hernia repairs can be performed under LA.

Although LA is routinely used in specialised hernia clinics such as the Scottish Hernia Centre, its use is still not a common practice in general hospitals, despite its proven benefits. Many current hernia repair guidelines suggest that inguinal hernia repair should be ideally performed under LA rather than general anaesthesia (GA).

There are a number of advantages to having your surgery performed under LA compared to GA and spinal /epidural type blocks.

Advantages of LA for groin hernia repairs

  1. It is safer as it avoids a GA. Although modern GA is incredibly safe, LA is perhaps even safer. This is especially so in frail or elderly patients where a GA may have a long lasting negative on memory and cognitive function. This also the case for individuals with other medical problems where GA may be a concern
  2. Better control of pain after the operation. As a consequence, less need for strong painkillers after surgery
  3. Our surgeons can check the repair by asking you to cough. This can help to both demonstrate the site of the weakness during the operation and can also be used to test that the repair is solid
  4. Shorter time in theatre and faster recovery period
  5. Most people can walk around immediately or soon after the operation. All this adds up to most patients being able to go home soon after the operation.
  6. You will be able to eat and drink more quickly after procedures under LA, leading to faster discharge
  7. You are less likely to suffer from nausea and vomiting which can be a side-effect of the drugs used in GA
  8. Inability to pass urine can occur after any hernia surgery but patients who undergo surgery under LA appear to be much less likely to have this problem
  9. LA appears to have much less impact on memory recall, attention and psychomotor skills compared to GA. This may be especially relevant in elderly patients and those with other medical problems

References

Local or General Anesthesia for Open Hernia Repair: A Randomized Trial. O’Dwyer PJ, Serpell MG, K Millar, et al. Ann Surg. 2003 Apr; 237(4): 574–579