Spinal Anesthesia Comparable Not Superior to General Anesthesia for Inguinal Hernia Repair: Study Reveals

Inguinal hernia repair is one of the most common surgical procedures performed worldwide. Among various approaches, Total Extra Peritoneal (TEP) repair is a minimally invasive technique that has gained popularity for treating inguinal hernias. However, one critical consideration in the procedure is the choice of anesthesia. Traditionally, general anesthesia has been used, but recent studies have raised the question of whether spinal anesthesia can be an equally effective or even better alternative.

Against the above background, Udita Mishra and Ghanashyam Thapa from the National Academy of Medical Sciences in Bir Hospital, Mahabouddha, Kathmandu, Nepal, aimed to compare the outcomes of Total Extra Peritoneal inguinal hernia repair performed under spinal anesthesia versus general anesthesia.

For this purpose, the researchers conducted a prospective cross-sectional study at Bir Hospital, focusing on patients undergoing Total Extra Peritoneal inguinal hernia repair under either spinal anesthesia or general anesthesia between September 2022 and August 2023. The study compared various factors, including operative time, postoperative hospitalization duration, postoperative pain, adverse effects, patient satisfaction levels, and the recurrence rate after one year.

The study led to the following findings:

• The study included fifty-eight patients, with 29 participants in each group: TEP-GA (general anesthesia) and TEP-SA (spinal anesthesia).
• All procedures were completed using the assigned anesthesia method.
• Pain scores were lower in the TEP-SA group during the initial four hours post-operation (2.79±1.08 for GA versus 1.99±0.97 for SA at one hour, and 2.28±1.09 for GA versus 1.80±0.80 for SA at four hours).
• There were no statistically significant differences between the two groups for surgery time, pain scores, complications, hospital stay, recovery, or recurrence.

The findings showed that spinal anesthesia is equally effective as general anesthesia for Total Extra Peritoneal inguinal hernia repair, and in some cases, it may even offer advantages.

"Given its potential to reduce complications associated with general anesthesia, spinal anesthesia can be a safer and more suitable option for patients who are at higher risk for general anesthesia. This makes spinal anesthesia a viable alternative, particularly in high-risk populations, offering similar outcomes with potentially fewer side effects," the researchers concluded.

Reference:

Mishra, U., & Thapa, G. (2024). Total extra peritoneal Repair of Inguinal Hernia under General Anesthesia Versus Spinal Anesthesia. Journal of Nepal Health Research Council, 22(03), 627-631. https://doi.org/10.33314/jnhrc.v22i03.5406