A Prospective Observational Study to Compare Quality of Life Following Lichtenstein Hernia Repair Under Spinal Versus Local Anesthesia

Abstract

 Introduction: Inguinal hernia is a common condition requiring surgical repair, with

millions of procedures performed annually. The Lichtenstein tension-free technique is widely preferred for its effectiveness. The choice of anesthesia-spinal or local-significantly impacts recovery, complications, and quality of life. Spinal anesthesia offers deeper pain relief, while local anesthesia ensures faster recovery and fewer complications, influencing surgical outcomes. Aim: To evaluate the anesthesia method that provides superior patient tolerance in open mesh repair of inguinal hernia. Materials and Methods: This prospective, comparative observational study was conducted atAIIMS Bhopal fromAugust 2022 to May 2024, involving 112 patients divided into two groups: Group A (spinal anesthesia, n=56) and Group B (local anesthesia, n=56). Parameters assessed included hospital stay, movement limitation, postoperative pain (VAS scores), quality of life (WHOQOL domains), and complications over a six-month follow-up. Statistical analyses were performed to evaluate differences. Results: The local anesthesia group had significantly shorter hospital stays (3.20 ± 0.73 vs. 4.86 ± 1.15 days; p=0.01) and fewer movement limitations (1.71 ± 0.56 vs. 2.07 ± 0.46 days; p<0.01). Pain levels were comparable, with minor differences at 1 month (p=0.03). Quality of life was initially higher in the spinal group but improved significantly in the local group in later periods, particularly in psychosocial and environmental domains. Urinary retention was noted in 10.7% of spinal cases but was absent in the local group (p=0.02). Other complications were similar. Conclusion: Local anesthesia is a safe and effective option for inguinal hernia repair, providing advantages such as shorter hospital stays, fewer complications, and better postoperative quality of life. These results highlight its suitability for selected patients, promoting faster recovery and improved outcomes.