An experience of open Mesh Hernioplasty under local anaesthesia

Abstract

BACKGROUND: Mesh repair is commonly used procedure for inguinal hernia. Many times elderly patients are not fit for general anesthesia so we had this study to know the outcome of mesh repair under local anesthesia. To determine the outcome of open mesh hernioplasty performed under local anesthesia in terms of perioperative complications.

OBJECTIVE: To prove the feasibility of inguinal hernia repair under local anesthesia

MATERIAL AND METHODS: This Descriptive study was conducted at Surgical Deptt. Saidu Teaching Hospital, Swat and Rahat Medical Centre Daggar, Buner from May 2008 to May 2016. A total of 520 male patients with inguinal hernias were subjected to open mesh hernioplasty (Standard Lichtenstein proline mesh tension free repair) after taking written informed consent. They were closely observed intra operatively and were then followed up for complications if any and data were collected through predesigned proforma and analyzed via computer soft ware.

RESULTS: Age of patients was within the range of 20 - 70 years. 432 (83%) of patients had mild or no pain( VAS Scale 0-3) while 73 ( 14%) had moderate ( VAS Scale 4-6) and 15 (3%) patients had severe ( VAS Scale 8-10. None of the patients developed any anaphylaxis during or after surgery.. Haematoma/ wound ecchymosis was seen in 21(about 4%) cases,11 cases (2%) had vomiting,5 patients (0.96%) had urinary retention,13 patients (2.5%) had minor wound infection with redness and oedema of the incision site and5 (0.96%) had recurrence of hernia.

CONCLUSION: Local anesthesia has easy applicability and very low rate of pain and post-operative complication. It also encourages early mobilization and early discharge from hospital. It is cost effective and reduces hospital burden. When all these advantages are taken in to consideration, local anaesthesia can be recommended as a safe and effective technique for inguinal hernia repair. In addition for patients who were un fit for general anaesthesia, local anaesthesia is a better alternative.