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Lichtenstein Tension Free Mesh Hernioplasty under Local Anaesthesia Versus Spinal Anaesthesia

Harish Chandra Dhamudia, Pabitra Hembram, Sumati Kandi, Ashok Kumar Nayak, Bikash Chandra Pal, Manoj P R..

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Background and Aim: The surgical repair of inguinal hernia is one of the most common general surgery procedures performed. The present study was undertaken to compare intra operative and postoperative outcomes of Lichtenstein tension free mesh hernioplasty under local anaesthesia as compared to spinal anaesthesia.
Materials and Methods: In this longitudinal study 100 patients aged between 20-80 years, posted for elective mesh hernioplasty were enrolled and divided into two groups. Group-L(n=50) hernioplasty done under local anaesthesia and Group-S(n=50) hernioplasty done under spinal anaesthesia. Patients were assessed for intraoperative comfort or pain felt during surgery, duration of surgery, postoperative pain score, postoperative analgesic doses required, duration of hospital stay and patient satisfaction.
Results: Intraoperative pain was comparable in both groups(p=0.695). There was statistically significant difference observed in duration of surgery(p=0.001), postoperative pain at 6hrs(p=0.001), 24hrs(p=0.009) and 48hrs(p=0.047). The mean duration of hospital stay was 2.12 ± 0.172 days in Group-L and 3.9 ± 1.1days in Group-S (p=0.001). The total incidence of postoperative complications seen in Group-L and in Group-S were 6% and 32% respectively which was statistically significant (p-0.001). In Group-L 84% of cases responded ‘satisfactory’ and in Group-S 80% responded ‘satisfactory’ at 6 weeks follow up, which was statistically not significant.
Conclusion: Lichtenstein tension free mesh hernioplasty under local anaesthesia can be used as a safer alternative to spinal anaesthesia with advantages of less postoperative pain and postoperative complications in uncomplicated inguinal hernia.

Key words: Lichtenstein mesh hernioplasty, local anaesthesia, spinal anaesthesia

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