Comparison of inguinal hernia repair under local anesthesia versus spinal anesthesia.

Goyal, Pradeep; Sharma, Shiv K.; Jaswal, Kamaljeet Singh; Goyal, Sandeep; Ahmed, Mushtaq; Sharma, G C; Pandotra, Poonam

doi:10.9790/0853-13165459

Cited by 12 publications

(21 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of the observational studies, one prospective and one retrospective cohort study found differences in urinary retention after different types of anaesthesia, but they were both excluded from meta‐analyses owing to the difference in study design. In total, nine RCTs were included in two meta‐analyses.…”

Section: Resultsmentioning

confidence: 99%

Network meta-analysis of urinary retention and mortality after Lichtenstein repair of inguinal hernia under local, regional or general anaesthesia

Olsen

Öberg

Andresen

et al. 2020

Journal of British Surgery

View full text Add to dashboard Cite

Background Urinary retention and mortality after open repair of inguinal hernia may depend on the type of anaesthesia. The aim of this study was to investigate possible differences in urinary retention and mortality in adults after Lichtenstein repair under different types of anaesthesia. Methods Systematic searches were conducted in the Cochrane, PubMed and Embase databases, with the last search on 1 August 2018. Eligible studies included adult patients having elective unilateral inguinal hernia repair by the Lichtenstein technique under local, regional or general anaesthesia. Outcomes were urinary retention and mortality, which were compared between the three types of anaesthesia using meta‐analyses and a network meta‐analysis. Results In total, 53 studies covering 11 683 patients were included. Crude rates of urinary retention were 0·1 (95 per cent c.i. 0 to 0·2) per cent for local anaesthesia, 8·6 (6·6 to 10·5) per cent for regional anaesthesia and 1·4 (0·6 to 2·2) per cent for general anaesthesia. No death related to the type of anaesthesia was reported. The network meta‐analysis showed a higher risk of urinary retention after both regional (odds ratio (OR) 15·73, 95 per cent c.i. 5·85 to 42·32; P < 0·001) and general (OR 4·07, 1·07 to 15·48; P = 0·040) anaesthesia compared with local anaesthesia, and a higher risk after regional compared with general anaesthesia (OR 3·87, 1·10 to 13·60; P = 0·035). Meta‐analyses showed a higher risk of urinary retention after regional compared with local anaesthesia (P < 0·001), but no difference between general and local anaesthesia (P = 0·08). Conclusion Local or general anaesthesia had significantly lower risks of urinary retention than regional anaesthesia. Differences in mortality could not be assessed as there were no deaths after elective Lichtenstein repair. Registration number: CRD42018087115 ( https://www.crd.york.ac.uk/prospero).

show abstract

Section: Resultsmentioning

confidence: 99%

Network meta-analysis of urinary retention and mortality after Lichtenstein repair of inguinal hernia under local, regional or general anaesthesia

Olsen

Öberg

Andresen

et al. 2020

Journal of British Surgery

View full text Add to dashboard Cite

show abstract

“…The authors concluded that tension-free mesh repair of inguinal hernias under local anesthesia is simple, safe, and cost-effective, with very low rates of complications and a speedy discharge [45].…”

Section: Primary Inguinal Hernia Repair In Patients With Severe Cardimentioning

confidence: 99%

“…A comparable study randomly divided 50 patients with Lichtenstein repair to local or spinal anesthesia [45]. The authors concluded that tension-free mesh repair of inguinal hernias under local anesthesia is simple, safe, and cost-effective, with very low rates of complications and a speedy discharge [45].…”

Section: Primary Inguinal Hernia Repair In Patients With Severe Cardimentioning

confidence: 99%

Current Concepts of Inguinal Hernia Repair

2018

View full text Add to dashboard Cite

With more than 20 million patients annually, inguinal hernia repair is one of the most often performed surgical procedures worldwide. The lifetime risk to develop an inguinal hernia is 27-43% for men and 3-6% for women. In spite of all advances, 11% of all patients suffer from a recurrence and 10-12% from chronic pain following primary inguinal hernia repair. By developing evidence-based guidelines and recommendations, the international hernia societies aim to improve the outcome of inguinal hernia repair due to standardization of care. From a total of more than 100 different repair techniques for inguinal and femoral hernias, classified as tissue repair, open mesh repair, and laparo-endoscopic mesh repair, the new International Guidelines of the Hernia-Surge Group only recommend the totally extraperitoneal patch plasty (TEP), transabdominal preperitoneal patch plasty (TAPP), and Lichtenstein techniques. Since a generally accepted technique suitable for all inguinal hernias does not exist, surgeons should provide both an anterior open (Lichtenstein) and a posterior laparo-endoscopic (TEP or TAPP) approach option. The guidelines strongly recommend that surgeons tailor the treatment of inguinal hernias based on expertise, local/national resources, and patient- and hernia-related factors. A tailored approach in inguinal hernia repair should pay heed to the patient- and hernia-related factors, unilateral hernia in men and women, bilateral hernia, recurrent hernia, scrotal hernia, previous pelvic and lower abdominal surgery, severe cardiac or pulmonary comorbidities, and incarcerated hernia.

show abstract

“…This data correlates with findings of Goyel. 15 They have concluded that local anaesthesia is better in terms of intra operative pain management but this result is contradicting the findings of Singh. 16 Postoperative pain is the most important variable and the soul of this study.…”

Section: Discussionmentioning

confidence: 93%

“…The difference observed in the two groups were not statistically significant, p=0.072. 15,[20][21][22][23][24] All of them have observed that postoperative pain is less with local anaesthesia but result not correlates with observation of Singh who had found postoperative pain is similar in both groups. 16 Postoperative pain control was better in local anaesthesia because pre-incisional field block with local anaesthesia reduces the build-up of nociceptor molecules and that also lasts for longer duration in the postoperative period.…”

Section: Discussionmentioning

confidence: 99%

A comparative study of Lichtenstein hernioplasty performed under spinal anaesthesia versus local anaesthesia in treatment of unilateral inguinal hernia

et al. 2019

View full text Add to dashboard Cite

Background: Lichtenstein mesh repair technique is widely used throughout the world in inguinal hernia repair. Hernioplasty done under local anaesthesia certainly has some benefits but it is yet to be proven as standard procedure. The aims of this study are to provide the data of a comparative study between Lichtenstein hernioplasties done under local versus spinal anaesthesia as well as add more data in this scenario.Methods: In this non randomized clinical study, 84 patients were selected by calculation of sample size. 42 patients were operated under spinal anaesthesia and another 42 were operated under local anaesthesia.Results: Mean duration of operation was slightly was slightly more in local anaesthesia i.e. 62.5 minutes (SD=17.8) versus 51.1 minutes (SD=21.5) in spinal anaesthesia. At 6 hours, 12 hours and 24 hours postoperative pain was significantly less in local anaesthesia group in comparison to spinal anaesthesia group with p=0.04, p=0.042, p=0.041 respectively. Postoperative complications like urinary retention, hypotension, and headache were more in spinal anaesthesia than in local anaesthesia. Duration of hospital stay was significantly less in local anaesthesia group i.e. 24.5 hours (SD=12.8) in comparison to spinal group 57.1 hours (SD=16.7).Conclusions:The study concludes that in local anaesthesia group, postoperative pain was significantly less and postoperative complications like urinary retention, headache, and hypotension were less evident compared to spinal anaesthesia. Hence the study concludes that local anaesthesia can be used as an alternative of spinal anaesthesia as a standard mode of anaesthesia for Lichtenstein hernioplasty operation.

show abstract

Comparison of inguinal hernia repair under local anesthesia versus spinal anesthesia.

Cited by 12 publications

References 19 publications

Network meta-analysis of urinary retention and mortality after Lichtenstein repair of inguinal hernia under local, regional or general anaesthesia

Network meta-analysis of urinary retention and mortality after Lichtenstein repair of inguinal hernia under local, regional or general anaesthesia

Current Concepts of Inguinal Hernia Repair

A comparative study of Lichtenstein hernioplasty performed under spinal anaesthesia versus local anaesthesia in treatment of unilateral inguinal hernia

Contact Info

Product

Resources

About