Inguinal Hernia Repair: A Comparative study between Inguinal Field Block and General Anaesthesia

INTRODUCTION: Inguinal hernia is a very common problem in the general population with a very high incidence. In fact, inguinal hernia is most common type of hernia. As a result of this high incidence, inguinal herniorraphy or hernioplasty is a commonly performed procedure. Hence, the plan of anaesthesia becomes very important. Most of the cases are done as a daycare procedure or with just one day of in-hospital stay and ideally, the plan of anaesthesia should be with the aim of quicker recovery, minimum side effects, maximum pain relief and good patient satisfaction. So, towards this end, a comparative study was done between local anaesthesia and general anaesthesia. AIM OF THE STUDY: The aim of this study is to compare the differences between local and general anaesthesia for inguinal hernia repair by comparing intra-op hemodynamic parameters, recovery profiles, post-op pain relief, post-op pain satisfaction, and post-op side effects. MATERIALS AND METHODS: A prospective, randomized study was conducted on 40 patients coming for inguinal hernia repair. They were randomly allocated into either local anaesthesia group or general anaesthesia group by flip of a coin. Study conducted after approval of institutional ethical committee and informed consent from the patient. Inclusion Criteria: 1. ASA Status I & II, 2. Age 18 to 65 years, 3. Weight 50 to 70 kg, 4. Elective procedure, 5. Unilateral, reducible inguinal hernia, 6. Mallampati Class I and II, 7. Mouth opening > 3 cm, 8. Neck movements adequate. Exclusion Criteria: 1. Patient refusal. 2. Active gastroesophageal reflux disease or other predisposing conditions for possible aspiration. 3. Significant neurological, psychiatric, cardiovascular, respiratory, renal or hepatic disease. 4. Any signs or conditions indicating anticipated difficult airway. 5. Not fulfilling inclusion criteria. STATISTICS: Statistical Methods Used: The descriptive statistics of the variables studied are represented as two-way tables. The categorical factors are represented by the number and frequency (%) of cases. The continuous variables are represented by measures of central frequency (like mean, median & mode) and deviation (standard deviation and range). The differences in the proportions are tested for statistical significance using non-parametric Chi-square test for variables measured on nominal scale. Fisher’s exact probability test was employed wherever required. For variables measured on a continuous scale, when testing for two groups, Student “t” test is used to test for statistical significance in the differences of the two means. SUMMARY: This study was conducted in unilateral inguinal hernia repairs as a comparative, randomized, prospective study between local anaesthesia and general anaesthesia. Taking into account inclusion criteria and exclusion criteria, the patients were randomly divided into local anaesthesia and general anaesthesia groups. The procedures for each group was meticulously followed and the patients followed up for 24 hours. The parameters that were compared in the study were noted down for each patient and the results computed using relevant statistical tests. CONCLUSION: Based on the parameters compared and the statistical analysis results, it is seen that inguinal hernia repair under local anaesthesia is better because it provides better recovery, better post-op pain relief and good patient satisfaction. The conclusions from this study is inguinal hernia repair done under local anaesthesia with ilio-inguinal, iliohypogastric nerve blocks with field block is a very effective and attractive alternative to general anaesthesia