Top

BMC Anesthesiology

Published in:

Open Access 01-12-2015 | Research article

Emergency inguinal hernia repair under local anesthesia: a 5-year experience in a teaching hospital

Authors: Tao Chen, Yunhe Zhang, Haolu Wang, Qihong Ni, Linhua Yang, Qiwei Li, Jian Wang

Published in: BMC Anesthesiology | Issue 1/2015

Abstract

Background

Local anesthesia (LA) has been reported to be the best choice for elective open inguinal hernia repair because it is cost efficient, with less post-operative pain and enables more rapid recovery. However, the role of LA in emergency inguinal hernia repair is still controversial. The aim of this study is to investigate the safety and effectiveness of LA in emergency inguinal hernia repair.

Methods

All patients underwent emergency inguinal hernia repair in our hospital between January 2010 and April 2014 were analyzed retrospectively in this study. Patients were divided into LA and general anesthesia (GA) group according to the general conditions of the patients decided by anesthetists and surgeons. The outcome parameters measured included time to recovery, early and late postoperative complications, total expense and recurrence.

Results

This study included a total of 90 patients from 2010 to 2015. 32 patients (35.6 %) were performed under LA, and 58 (64.4 %) were performed under GA. LA group has less cardiac complications (P = 0.044) and respiratory complications (P = 0.027), shorter ICU stay (P = 0.035) and hospital stay (P = 0.001), lower cost (P = 0.000) and faster recovery time (P = 0.000) than GA group.

Conclusion

LA could provide effective anesthesia and patient safety in emergency inguinal hernia repair.

Lomanto D, Cheah WK, Faylona JM, et al. Inguinal hernia repair: toward Asian guidelines. Asian J Endosc Surg. 2015;8(1):16–23.CrossRefPubMed

Kulah B, Duzgun AP, Moran M, et al. Emergency hernia repairs in elderly patients. Am J Surg. 2001;182(5):455–9.CrossRefPubMed

Kjaergaard J, Bay-Nielsen M, Kehlet H. Mortality following emergency groin hernia surgery in Denmark. Hernia. 2010;14(4):351–5.CrossRefPubMed

Rosenberg J, Bisgaard T, Kehlet H, et al. Danish Hernia Database recommendations for the management of inguinal and femoral hernia in adults. Dan Med Bull. 2011;58(2):C4243.PubMed

Nordin P, Zetterstrom H, Carlsson P, et al. Cost–effectiveness analysis of local, regional and general anaesthesia for inguinal hernia repair using data from a randomized clinical trial. Br J Surg. 2007;94(4):500–5.CrossRefPubMed

O’Dwyer PJ, Serpell MG, Millar K, et al. Local or general anesthesia for open hernia repair: a randomized trial. Ann Surg. 2003;237(4):574–9.PubMedPubMedCentral

Reece-Smith AM, Maggio AQ, Tang TY, et al. Local anaesthetic vs. general anaesthetic for inguinal hernia repair: systematic review and meta-analysis. Int J Clin Pract. 2009;63(12):1739–42.CrossRefPubMed

David S, Martin K, et al. Groin hernia guidelines, Association of Surgeons of Great Britain and Ireland, Available at: http://www.asgbi.org.uk/download.cfm?docid=21BC920F-290E-4CDE-B415CA77DFF1E0A0

Simons MP, Aufenacker T, Bay-Nielsen M, et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2009;13(4):343–403.CrossRefPubMedPubMedCentral

10.

Sanjay P, Woodward A. Inguinal hernia repair: local or general anaesthesia? Ann R Coll Surg Engl. 2007;89(5):497–503.CrossRefPubMedPubMedCentral

11.

Amato B, Compagna R, Della Corte GA, et al. Feasibility of inguinal hernioplasty under local anaesthesia in elderly patients. BMC Surg. 2012;12 Suppl 1:S2.CrossRefPubMed

12.

Nordin P, Zetterstrom H, Gunnarsson U, Nilsson E. Local, regional, or general anaesthesia in groin hernia repair: multicentre randomised trial. Lancet. 2003;362:853–8.CrossRefPubMed

13.

Nordin P, Hernell H, Unosson M, et al. Type of anaesthesia and patient acceptance in groin hernia repair: a multicentre randomised trial. Hernia. 2004;8:220–5.CrossRefPubMed

14.

Teasdale C, McCrum AM, Williams NB, et al. A randomised controlled trial to compare local with general anaesthesia for short-stay inguinal hernia repair. Ann R Coll Surg Engl. 1982;64:238–42.PubMedPubMedCentral

15.

Kurmann A, Fischer H, Dell-Kuster S, et al. Effect of intraoperative infiltration with local anesthesia on the development of chronic pain after inguinal hernia repair: a randomized, triple-blinded, placebo-controlled trial. Surgery. 2015;157(1):144–54.CrossRefPubMed

16.

Dabić D, Perunicić V, Marić B. “One step procedure” local anaesthesia for inguinal hernia repair in ambulatory surgery conditions--district general hospital experience. Acta Chir Iugosl. 2012;59(1):87–93.CrossRefPubMed

17.

Bhattacharya P, Mandal MC, Mukhopadhyay S, et al. Unilateral paravertebral block: an alternative to conventional spinal anaesthesia for inguinal hernia repair. Acta Anaesthesiol Scand. 2010;54(2):246–51.CrossRefPubMed

18.

Compagna R, Vigliotti G, Coretti G, et al. Comparative study between Levobupivacaine and Bupivacaine for hernia surgery in the elderly. BMC Surg. 2012;12 Suppl 1:S12.CrossRefPubMed

19.

Milone M, Di Minno MN, Musella M, et al. Outpatient inguinal hernia repair under local anaesthesia: feasibility and efficacy of ultrasound-guided transversus abdominis plane block. Hernia. 2013;17(6):749–55.CrossRefPubMed

20.

Kulacoglu H, Ergul Z, Esmer AF, et al. Percutaneous ilioinguinal-iliohypogastric nerve block or step-by-step local infiltration anesthesia foringuinal hernia repair: what cadaveric dissection says? J Korean Surg Soc. 2011;81(6):408–13.CrossRefPubMedPubMedCentral

21.

De Sá Ribeiro FA, Padron F, Castro TD, et al. Inguinal hernia repair with local anesthesia in the outpatient. Rev Col Bras Cir. 2010;37(6):397–402.CrossRefPubMed

22.

Amid PK, Shulman AG, Lichtenstein IL. Open “tension-free” repair of inguinal hernias: the Lichtenstein technique. Eur J Surg. 1996;162:447–53.PubMed

23.

Paajanen H, Varjo R. Ten-year audit of Lichtenstein hernioplasty under local anaesthesia performed by surgical residents. BMC Surg. 2010;4(10):24.CrossRef

24.

De Martino A, Testi W, Cirianni D, et al. Incarcerated inguinal hernia in elderly: personal tension-free hernioplastic technique. Ann Ital Chir. 2007;78(3):221–5.PubMed

25.

Yang L, Wang H, Liang X, et al. Bacteria in hernia sac: an important risk fact for surgical site infection after incarcerated hernia repair. Hernia. 2015;19(2):279–83.CrossRefPubMed

26.

Kehlet H, Bay-Nielsen M. Local anaesthesia as a risk factor for recurrence after groin hernia repair. Hernia. 2008;12(5):507–9.CrossRefPubMed

Title: Emergency inguinal hernia repair under local anesthesia: a 5-year experience in a teaching hospital
Authors: Tao Chen
Yunhe Zhang
Haolu Wang
Qihong Ni
Linhua Yang
Qiwei Li
Jian Wang
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: BMC Anesthesiology / Issue 1/2015
Electronic ISSN: 1471-2253
DOI: https://doi.org/10.1186/s12871-016-0185-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Emergency inguinal hernia repair under local anesthesia: a 5-year experience in a teaching hospital

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2015

Sudden occurence of hypotension and bradycardia during greenlight laser transurethral resection of prostate: case report of two cases

Lung hyperaeration assessment by computed tomography: correction of reconstruction-induced bias

Perceptions about the relative importance of patient care-related topics: a single institutional survey of its anesthesiologists, nurse anesthetists, and surgeons

Critical care provision after colorectal cancer surgery

The antioxidant N-acetyl cysteine suppresses lidocaine-induced intracellular reactive oxygen species production and cell death in neuronal SH-SY5Y cells

Effects of omega-3 fatty acid nutrition on mortality in septic patients: a meta-analysis of randomized controlled trials