M. S. Sultany1, V. Jain1, J. Imran1, S. Huerta1,2 1University Of Texas Southwestern Medical Center,Department of Surgery,Dallas, TX, USA 2VA North Texas Health Care System,Department Of Surgery,Dallas, TX, USA
Introduction:
Inguinal hernia repair (IHR) is typically performed under general anesthesia (GA). However, in select patients who are high-risk for surgery under GA, repair under local anesthesia (LA) can be performed safely. There is a paucity of data comparing the outcomes of IHR with either LA or GA. The objective of this study is to compare operative time and postoperative outcomes of patients undergoing IHR with LA to those under GA.
Methods:
A retrospective review of patients undergoing IHR from 2005-2016 was performed. Patient cohorts were divided into those undergoing IHR with either LA or GA. Patient demographics, preoperative data, operative time and postoperative outcomes were analyzed using chi-square test for categorical data and Student’s t-test for continuous variables.
Results:
A total of 931 patients were included in the study, of which 858 patients out of 931 (92 %) underwent IHR with GA and 73 patients (8 %) with LA. Patients undergoing IHR with LA had a higher mean age (68 years vs. 60 years). On univariate analysis, there were no differences in postoperative outcomes such as inguinodynia (1.8 % vs. 1.3 %, p = 0.78), recurrence rate (7.4 % vs. 9.5 %, p = 0.85) and hospital length of stay (0.373 vs. 0.057 days, p = 0.30) for those undergoing IHR with GA versus LA. In addition, there were no differences between groups with respect to the type of inguinal hernia (bilateral, unilateral or incarcerated), body mass index, American Society of Anesthesiologists (ASA) class or operative time.
Conclusion:
There is no difference in operative time, rate of inguinodynia, recurrence or hospital length of stay between patients undergoing IHR with either LA or GA. IHR with LA should be considered in select patients who are high-risk for surgery under GA.