• Muhammad Kashif Rafiq Ayub Teaching Hospital, Abbottabad
  • Babar Sultan
  • Masood Akhtar Malik
  • Khalid Khan
  • Munir Ahmad Abbasi
  • Khalid Khan


Background: Local anaesthesia has been identified as the most favourable anaesthesia for elective inguinal hernia repair with respect to complication rate, cost effectiveness and overall patients’ satisfaction. This study was conducted to determine the efficacy of local anaesthesia in inguinal hernia in terms of pain relief, wound infection and hospital stay. Methods: In this randomized controlled trial (RCT), 60 patients with inguinal hernia were included at the General Surgical ‘B’ Unit, Ayub Teaching Hospital Abbottabad. Results: The day-case rates were significantly higher when patients underwent surgery under LA compared to GA (82.6% versus 42.6%). The incidence of urinary retention was higher in the GA group (p<0.05). There were 17 (2.9%) re-admissions overall. The reasons for re-admission included haematoma (n=6), severe pain (n=4), infection (n=3), fainting (n=2) and urinary retention (n=2). Conclusion: This study demonstrates that local anaesthesia for inguinal hernia repair has better efficacy as compared to general anaesthesia.Keywords: General anaesthesia; local anaesthesia; inguinal hernia; Comparison

Author Biographies

Muhammad Kashif Rafiq, Ayub Teaching Hospital, Abbottabad

Senior RegistrarSurgical A Unit,Ayub Teaching Hospital, Abbottabad

Babar Sultan

Assistant ProfessorSurgical A Unit,Ayub Teaching Hospital, Abbottabad

Masood Akhtar Malik

Assistant ProfessorSurgical A Unit,Ayub Teaching Hospital, Abbottabad


Sinha R, Rajiah P, Tiwary P. Abdominal Hernias: Imaging Review and Historical Perspectives. Curr Probl Diagn Radiol 2007;36(1):30–42.

Javid P, Brooks D. Hernias. In: Ashley SW, Zinner M, Maingot R, editors. Maingot’s abdominal operations. 11th ed. New York: McGraw-Hill Publishing; 2007. p.103–40.

Sorensen L, Jorgensen L, Gottrup F. Biochemical aspects of abdominal wall hernia formation and recurrence. In: Fitzgibbons RJ, Greenburg AG, Nyhus LM, editors. Nyhus and Condon’s hernia. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2002. p.9–16.

Legutko J, Pach R, Solecki R, Matyja A, Kulig J. The history of treatment of groin hernia. Folia Med Cracov 2008;49(1-2):57–74.

Cheek C, Kingsnorth A. Inguinal and femoral hernias. In: Morris PJ, Malt RA, editors. Oxford textbook of surgery. 2nd ed. New York: Oxford University Press; 1994. p.1867–76.

Velanovich V, Shadduck P, Khaitan L, Morton J, Maupin G, Traverso LW. Analysis of the SAGES Outcomes Initiative groin hernia database. Surg Endosc 2006;20(2):191–8.

Malangoni M, Gagliardi R. Hernias. In: Courtney M. Townsend JMD, Beauchamp RD, Evers BM, Mattox KL, editors. Sabiston Textbook Of Surgery [Internet]. Elsevier Science Health Science Division; 2004. [cited 2016 Feb 8]. Available from: https://books.google.com.pk/books?id=iePRAAAACAAJ

Spector S, Rosenthal R. Abdominal wall hernia in the elderly. In: Rosenthal RA, Zenilman ME, Katlic MR, editors. Principles and practice of geriatric surgery. Springer New York; 2001. p.662–74.

el Qaderi S, Aligharaibeh KI, Hani IB, Gassaimeh G, Ammari F. Hernia in northern Jordan. Some epidemiological considerations. Trop Geogr Med 1992;44(3):281–3.

Dahlstrand U, Wollert S, Nordin P, Sandblom G, Gunnarsson U. Emergency femoral hernia repair: a study based on a national register. Ann Surg 2009;249(4):672–6.

Wantz G. Abdominal Wall Hernias. In: Brunicardi FC, Schwartz SI, editors. Schwartz’s principles of surgery. 8th ed. New York: McGraw-Hill, Health Pub. Division; 2005. p.1585–611.

Skandalakis PN, Zoras O, Skandalakis JE, Mirilas P. Richter hernia: surgical anatomy and technique of repair. Am Surg 2006;72(2):180–4.

Kingsnorth AN, Giorgobiani G, Bennett DH. Hernias, umbilicus, abdominal wall. In: Williams NS, Bulstrode CJK, O'Connell PR Bailey & Love's Short Practice of Surgery. 25th ed. London: Hodder Arnold; 2008. p.968–90.

Nordin P, Zetterström H, Carlsson P, Nilsson E. Cost-effectiveness analysis of local, regional and general anaesthesia for inguinal hernia repair using data from a randomized clinical trial. Br J Surg 2007;94(4):500–5.

Koch A, Edwards A, Haapaniemi S, Nordin P, Kald A. Prospective evaluation of 6895 groin hernia repairs in women. Br J Surg 2005;92(12):1553–8.

Chan G, Chan CK. Longterm results of a prospective study of 225 femoral hernia repairs: indications for tissue and mesh repair. J Am Coll Surg 2008;207(3):360–7.

Ahmed JU, Hussain MM, Karim M, Chowdhury SA, Rahman M, Noor S. Management of external hernias: analysis of 1020 [corrected] cases. Mymensingh Med J 2006;15(2):163–9.

Malik AM, Jawaid A, Talpur AH, Laghari AA, Khan A. Mesh versus non-mesh repair of ventral abdominal hernias. J Ayub Med Coll Abbottabad 2008;20(3):54–6.

Mirza MS. Incarcerated Littre’s femoral hernia: case report and review of the literature. J Ayub Med Coll Abbottabad 2007;19(2):60–1.




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