Hernia repair under local anesthesia

ABSTRACT

To describe hernia repair under local anesthesia with regard to the technique, morbidity and hospital admissions after the procedure. Two-hundred hernia repairs were performed under local anesthesia for 178 patients at King Hussein Medical Center and at Prince Hashem Hospital between January 2005 and January 2007. All patients were assessed preoperatively by a senior surgeon and written consent was obtained. The anesthesia protocol used included 0.5% lignocaine and 0.25% bupivacaine as local anesthesia supplemented with intravenous sedation by the anesthesiologist as necessary. Patients were monitored intraoperatively for heart rate, blood pressure and pulse oximetry. The procedure was successfully performed for 197 hernias under local anesthesia. Only three patients required general anesthesia. The first 50 patients were admitted overnight for observation, the rest were all planned as day case surgeries and were followed up over a three month period. Four patients developed wound hematoma, two patients developed wound infection, one patient developed post operative urine retention, and two patients showed evidence of recurrence when reviewed after one year. Our study confirmed the safety and convenience of using local anesthesia for hernia repair. Less post operative discomfort and low morbidity rate was obtained. Hernia repair under local anesthesia can be learnt easily and quickly, therefore it is the recommended procedure to be used in our practice for the repair of inguinal hernia