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Annals of Surgery:
doi: 10.1097/SLA.0b013e318165b0ff
Randomized Controlled Trials

Spinal or Local Anesthesia in Lichtenstein Hernia Repair: A Randomized Controlled Trial

van Veen, Ruben N. MD*; Mahabier, Chander MD, PhD†; Dawson, Imro MD, PhD‡; Hop, Wim C. PhD§; Kok, Niels F. M. MD*; Lange, Johan F. MD, PhD*; Jeekel, Johannus MD, PhD*

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Abstract

Background: With established protocols lacking, the choice of anesthetic technique remains arbitrary in inguinal hernia repair. Well-designed studies in this subject are important because of the gap or discrepancy between available scientific evidence and clinical practice.

Methods: Between August 2004 and June 2006, a multicenter prospective clinical trial was performed in which 100 patients with unilateral primary inguinal hernia were randomized to spinal or local anesthesia. Clinical examination took place within 2 weeks postoperatively and at 3 months in the outpatient clinic.

Results: Analysis of postoperative visual analogue scale scores showed that patients operated under local anesthesia had significant less pain shortly after surgery (P = 0.021). Significantly more urinary retention (P < 0.001) and more overnight admissions (P = 0.004) occurred after spinal anesthesia. Total operating time is significantly shorter in the local anesthesia group (P < 0.001). No significant differences were found between the 2 groups with respect to the activities of daily life and quality of life.

Conclusions: Our study provides evidence that local anesthesia is superior to spinal anesthesia in inguinal hernia repair. Local anesthesia in primary, inguinal hernia repairs should be the method of choice.

© 2008 Lippincott Williams & Wilkins, Inc.

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