A Comparative Study of Local Versus Spinal Anaesthesia in Lichtenstein Inguinal Hernioplasty: A Prospective Randomized Controlled Trial
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Abstract
Introduction: Inguinal hernia repair is among the most common surgical procedures globally, with Lichtenstein mesh hernioplasty being the standard technique due to its simplicity and low recurrence rate. However, the choice of anaesthesia—local or spinal—plays a pivotal role in influencing intraoperative and postoperative outcomes. While spinal anaesthesia (SA) is widely used in India, local anaesthesia (LA) is gaining attention for its potential benefits, especially in day-care surgery.
Aim and Objective: This study aims to compare the clinical outcomes of Lichtenstein inguinal hernioplasty performed under local versus spinal anaesthesia, focusing on intraoperative difficulties, postoperative pain, complications, hospital stay, and overall recovery.
Materials and Methods: A prospective randomized controlled trial at J.A. Group of Hospitals, Gwalior (June 2023–December 2024), included 94 male patients with unilateral, reducible inguinal hernia. They were randomly divided into two groups: local anaesthesia (Group A) and spinal anaesthesia (Group B), with 47 patients each. Key outcomes assessed included intraoperative pain (VAS), operative duration, postoperative pain at various intervals, complications such as urinary retention, headache, infections, and total hospital stay.All data were statistically evaluated for comparison between the groups.
Results: Both groups were similar in demographics, hernia type, intraoperative pain, and operative time. Postoperative pain was significantly lower in the local anaesthesia group. Urinary retention and headache were more frequent in the spinal anaesthesia group. Hospital stay was shorter in the local group, indicating faster recovery and improved postoperative outcomes.
Conclusion: Local anaesthesia is a safe, effective, and economical alternative to spinal anaesthesia for inguinal hernioplasty, offering superior postoperative recovery, fewer complications, and reduced hospital stay.