PROSPECTIVE INTERVENTIONAL STUDY ON CLINICAL OUTCOMES OF LICHTENSTEIN'S TENSION FREE INGUINAL HERNIOPLASTY UNDER LOCAL ANAESTHESIA IN A TERTIARY CARE HOSPITAL IN EASTERN INDIA

BACKGROUND Repair of inguinal hernia is one of the most common operations performed by general surgeons worldwide. This study demonstrates the feasibility of inguinal hernia repair under local anaesthesia with intravenous sedation and analgesia with safety, efficacy and acceptability. METHODS A prospective study was conducted in the Department of General Surgery in a tertiary care medical college and hospital. Patients admitted in wards with inguinal hernia from General Surgery Out Patient Department were selected for this study. The series consisted of 60 patients between 15 and 74 years. The study period is from April 2007 to September 2008. These 60 patients had complaints of groin swelling, in right side 35 patients, or left side 23 patients, and both sides 2 patients. Most of them were reducible. All adult patients suffering from inguinal hernia were included in the study. The exclusion criteria were- obstructed or strangulated hernia, extremes of age, terminal malignancy, advanced diabetes, renal failure and psychiatric disorder. Hernioplasty was done under local anaesthesia with an average of 45 ml of mixture of 1% lidocaine and 0.5% bupivacaine with or without 1/200000 epinephrine for a unilateral inguinal hernia repair. All patients underwent elective surgery and were analysed with regard to surgical outcome, complications, cost effectiveness, acceptability and hospital stay. RESULTS In our study, 21 cases had early minor complications. There was no recurrence and no mortality. CONCLUSIONS It is an advantageous procedure because of feasibility, efficacy, greater safety, better post-operative pain control, satisfactory patient acceptance, lower operative time, early return to work and reduced cost.